ArticleCommunications medicine2023
Waist-hip ratio is superior to BMI in predicting liver-related outcomes and synergizes with harmful alcohol use.
Article in Communications medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 16 citations in OpenAlex.
- Role of systemic and epicardial adipose tissue in cardiometabolic disease.Nature reviews. Cardiology · 2026Review
- Associations between adiposity indices and liver steatosis and stiffness assessed by two-dimensional shear wave elastography in patients with type 2 diabetes mellitus: a cross-sectional study.BMC endocrine disorders · 2026Article
- Association of general obesity, metabolically healthy obesity, and abdominal adiposity markers with elevated liver enzymes: a population-based study.Scientific reports · 2026Article
- Predicting MASLD in People With HIV Using Anthropometric Measures: A Multicenter Cross-Sectional Study.Open forum infectious diseases · 2026Article
- Disentangling the Effect of BMI on Hepatocellular Carcinoma From Cirrhosis With Multivariable Mendelian Randomization.Liver international : official journal of the International Association for the Study of the Liver · 2026Article
- Obesity and Heart Failure: Introducing the Theme.Journal of cardiovascular development and disease · 2026Review
- Diagnosis of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) at Risk for Advanced Fibrosis in a Real-World Primary Care Setting: A Cross-Sectional Study.Journal of general internal medicine · 2026Article
- Clinical trial design, biomarkers and end points in metabolic and alcohol-related liver disease.Nature reviews. Gastroenterology & hepatology · 2025Review
- Prevalence of high waist to hip ratio and its association with hypertension among married couples in India: A cross-sectional study.American journal of preventive cardiology · 2025Article
- Large-Scale Evaluation and Liver Disease Risk Prediction in Finland's National Electronic Health Record System: Feasibility Study Using Real-World Data.JMIR medical informatics · 2025Article
- Prehypertension and its associated factors among government employees in Tilottama Municipality of Rupandehi District, Nepal.PloS one · 2025Article
- Causal Relationships Between Abdominal Obesity, Type 2 Diabetes, Fasting Insulin, and Cervical Disc Disorders, Osteoporosis, and Rheumatoid Arthritis: A Mendelian Randomization Study.Journal of multidisciplinary healthcare · 2025Article
- H-NMR metabolomics identifies three distinct metabolic profiles differentially associated with cardiometabolic risk in patients with obesity in the Di@bet.es cohort.Cardiovascular diabetology · 2024Article
- Waist-to-hip ratio and nonalcoholic fatty liver disease: a clinical observational and Mendelian randomization analysis.Frontiers in nutrition · 2024Article
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundObesity is associated with liver disease, but the best obesity-related predictor remains undefined. Controversy exists regarding possible synergism between obesity and alcohol use for liver-related outcomes (LRO). We assessed the predictive performance for LROs, and synergism with alcohol use, of abdominal obesity (waist-hip ratio, WHR), and compared it to overall obesity (body mass index, BMI).
methodsForty-thousand nine-hundred twenty-two adults attending the Finnish health-examination surveys, FINRISK 1992-2012 and Health 2000 studies, were followed through linkage with electronic healthcare registries for LROs (hospitalizations, cancers, and deaths). Predictive performance of obesity measures (WHR, waist circumference [WC], and BMI) were assessed by Fine-Gray models and time-dependent area-under-the-curve (AUC).
resultsThere are 355 LROs during a median follow-up of 12.9 years (509047.8 person-years). WHR and WC emerge as more powerful predictors of LROs than BMI. WHR shows significantly better 10-year AUC values for LROs (0.714, 95% CI 0.685-0.743) than WC (0.648, 95% CI 0.617-0.679) or BMI (0.550, 95% CI 0.514-0.585) both overall and separately among men and women. WHR is predictive also in BMI strata. Absolute 10-year risks of LROs are more dependent on WHR than BMI. Moreover, WHR shows a significant supra-additive interaction effect with harmful alcohol use for liver-related outcomes (excess 10-year cumulative incidence of 2.8% from the interaction), which is not seen between BMI and harmful alcohol use.
conclusionsWHR is a better predictor than BMI or WC for LROs, and WHR better reflects the synergism with harmful alcohol use. WHR should be included in clinical assessment when evaluating obesity-related risks for liver outcomes.
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