Nine anthropometric indices predict hepatic steatosis and assess liver health in adolescents: a population-based study.

Purpose: The increasing prevalence of obesity among adolescents has resulted in an increase in the incidence of hepatic steatosis; however, the relationship between anthropometric measurements and this condition in youth remains underexplored. Aims: To evaluate the effectiveness of nine anthropometric indicators in predicting the risk of hepatic steatosis in adolescents. Methods: We assessed several anthropometric indicators, including the abdominal volume index (AVI), body mass index, body roundness index, body adiposity index, conicity index, waist-hip ratio, waist-to-height ratio, and weight-adjusted waist index. Statistical methods such as multivariate logistic regression, smooth curve fitting, and subgroup analysis were employed. Discriminative accuracy was determined using receiver operating characteristic curve analysis, and a tool based on the optimal Youden index was developed. Results: All nine indices were significantly correlated with hepatic steatosis in adolescents. AVI demonstrated the strongest predictive ability, with an area under the curve of 0.8454 (95% confidence interval: 0.8221-0.8687, best threshold: 14.9992). Variations in predictive accuracy were observed across racial and ethnic subgroups, highlighting the importance of demographic factors. Conclusion: All nine anthropometric indices are associated with hepatic steatosis, with AVI emerging as the most effective tool for assessing liver health in adolescents.