Assessment indicators of steatotic liver disease in non-hepatology specialty clinics: A real-world retrospective case-control study

Table 1 Univariate analysis of the association between categorical variables and steatotic liver disease

Categorical variables	Case group (n = 273)		Control group (n = 244)		χ2	P value
	Number	Composition ratio (%)	Number	Composition ratio (%)
Gender					46.923	< 0.0001
Male	159	58.24	69	28.28
Female	114	41.76	175	71.72
Diabetes					5.480	0.019
Yes	27	9.89	11	4.51
No	246	90.11	233	95.49

Table 2 Variables with no collinearity

	Tolerance	VIF
Gender	0.426	2.35
Diabetes	0.97	1.031
NC	0.14	7.167
TyG-WHtR1	0.145	6.897
HSI	0.245	4.085
CVAI	0.571	1.75
Thigh circumference	0.206	4.85
ALM%	0.219	4.559
Waist-to-hip ratio	0.197	5.088
	Tolerance > 0.1	VIF < 10

¹By gradually eliminating the variables, the Tolerance > 0.1 and variance inflation factor < 10 was obtained, and there was no collinearity variable.

VIF: Variance inflation factor; TyG-WHtR: Triglyceride glucose-waist-to-height ratio; HSI: Hepatic steatosis index; CVAI: Chinese Visceral Adiposity Index; ALM%: The sum of the muscle mass percentages of right upper limb, right lower limb, left upper limb, and left lower limb, muscle mass percentage = muscle mass/ideal muscle mass × 100; NC: Neck circumference.

Table 3 After removing collinearity, one-way analysis of the association between continuous variables and steatotic liver disease

Continuous variables	SLD (n = 273)	Non-SLD (n = 244)	P value	T/U
NC, means (SE)	40.03 (3.63)	34.66 (4.27)	< 0.0001	15.445
Waist-to-hip ratio, means (SE)	0.98 (0.06)	0.89 (0.07)	< 0.0001	15.013
TyG-WHtR1, median (IQR)	5.57 (5.09-6.01)	4.34 (3.79-4.95)	< 0.0001	8275.000
HSI, means (SE)	44.11 (7.08)	33.94 (7.66)	< 0.0001	15.497
CVAI1, median (IQR)	145.31 (107.11-191.65)	63.45 (33.44-98.05)	< 0.0001	8993.000
Thigh circumference1, median (IQR)	59.70 (56.03-63.50)	52.28 (48.10-56.98)	< 0.0001	12359.500
ALM%, means (SE)	463.93 (56.28)	405.13 (56.20)	< 0.0001	11.866

¹Because it does not conform to the normal distribution, the Mann-Whitney test is used.

TyG-WHtR: Triglyceride glucose-waist-to-height ratio; SLD: Steatotic liver disease; IQR: Interquartile range; HSI: Hepatic steatosis index; CVAI: Chinese Visceral Adiposity Index; ALM%: The sum of the muscle mass percentages of right upper limb, right lower limb, left upper limb, and left lower limb, muscle mass percentage = muscle mass/ideal muscle mass × 100; NC: Neck circumference.

Table 4 The results of logistic regression analysis showed three parameters that were significantly associated with steatotic liver disease

	B	SE	Wald	df	P value	Exp (B)	95% EXP (B)
Gender	1.551	0.409	14.354	1	< 0.0001	4.717	2.114	10.523
Diabetes	0.451	0.550	0.675	1	0.411	1.571	0.535	4.612
NC	-0.193	0.077	6.212	1	0.013	0.824	0.708	0.960
TyG-WHtR	2.020	0.395	26.121	1	< 0.0001	7.536	3.473	16.350
CVAI	0.018	0.003	36.531	1	< 0.0001	1.018	1.012	1.024
HSI	0.041	0.029	2.005	1	0.157	1.042	0.984	1.103
Thigh circumference	-0.060	0.043	2.012	1	0.156	0.941	0.866	1.023
Waist-to-hip ratio	1.829	3.820	0.229	1	0.632	6.225	0.003	11108.643
ALM%	0.010	0.005	4.377	1	0.036	1.010	1.001	1.019
Constant	-9.726	2.563	14.396	1	< 0.0001	0.000

TyG-WHtR: Triglyceride glucose-waist-to-height ratio; HSI: Hepatic steatosis index; CVAI: Chinese Visceral Adiposity Index; ALM%: The sum of the muscle mass percentages of right upper limb, right lower limb, left upper limb, and left lower limb, muscle mass percentage = muscle mass/ideal muscle mass × 100; NC: Neck circumference.

Table 5 Quartile-specific prevalence of steatotic liver disease according to triglyceride glucose-waist-to-height ratio levels

Quartile	TyG-WHtR range	n	SLD cases	SLD prevalence (%)	Unadjusted OR (95%CI)
Q1 (lowest)	≤ P25	129	7	5.4	1.00 (Reference)
Q2	P25-P50	129	57	44.2	13.80 (5.97-31.88)
Q3	P50-P75	130	94	72.3	45.51 (19.39-106.80)
Q4 (highest)	> P75	129	115	89.1	143.16 (55.80-366.90)
P for trend					< 0.0001

TyG-WHtR: Triglyceride glucose-waist-to-height ratio; SLD: Steatotic liver disease; OR: Odds ratio; CI: Confidence interval.

Table 6 Quartile-specific prevalence of steatotic liver disease according to Chinese Visceral Adiposity Index levels

Quartile	CVAI range	n	SLD cases	SLD prevalence (%)	Unadjusted OR (95%CI)
Q1 (lowest)	≤ P25	129	7	5.4	1.00 (Reference)
Q2	P25-P50	129	57	44.2	13.80 (5.97-31.88)
Q3	P50-P75	130	92	70.8	42.20 (18.00-98.70)
Q4 (highest)	> P75	129	117	90.7	169.93 (64.70-446.60)
P for trend					< 0.0001

SLD: Steatotic liver disease; OR: Odds ratio; CVAI: Chinese Visceral Adiposity Index; CI: Confidence interval.

Table 7 The predictive power of two associated parameters

Variable	AUC (95%CI)	Cut-off values	Specificity (%)	Sensitivity (%)	PPV	NPV	P value
TyG-WHtR	0.876 (0.846-0.905)	4.787	68.852	91.209	76.615	87.5	< 0.0001
CVAI	0.865 (0.834-0.896)	101.9	78.689	80.524	76.8	80.48	< 0.0001

TyG-WHtR: Triglyceride glucose-waist-to-height ratio; CVAI: Chinese Visceral Adiposity Index; CI: Confidence interval; PPV: Positive predictive value; NPV: Negative predictive value; AUC: Area under the receiver operating characteristic curve.

Table 8 Numerical distribution of the three correlation parameters in steatotic liver disease with different degrees of fat deposition

	Moderate to severe SLD (n = 148)	Mild SLD (n = 125)	Non-SLD (n = 224)	P value	U/χ2
CVAI, median (IQR)	162.37 (113.10-205.13)	139.36 (106.95-174.90)	63.45 (33.44-98.05)	< 0.0001	221.283
TyG-WHtR, median (IQR)	4.73 (4.31-5.27)	4.64 (4.23-5.04)	4.34 (3.79-4.95)	< 0.0001	205.628
Gender				< 0.0001	47.393
Male	89	70	69
Female	59	55	175

SLD: Steatotic liver disease; TyG-WHtR: Triglyceride glucose-waist-to-height ratio; CVAI: Chinese Visceral Adiposity Index; IQR: Interquartile range.