Relative fat mass and risk of metabolic dysfunction associated steatotic liver disease and severe hepatic steatosis in U.S. adults: analysis of NHANES 2017–2020 data

Abstract Background Relative fat mass (RFM) is a novel, easily calculated, and cost-effective index of fat content and distribution in the body, associated with the odds of developing various obesity-related diseases. However, its association with metabolic dysfunction associated steatotic liver dis...

Full description

Saved in:
Bibliographic Details
Main Authors: Jianjun Wang, Wei He, Xianfu Cai, Zhaohui Hu, Yonghai Peng, Xi Chen, Pei Yang, Xintao Zeng, Sirui Chen, Decai Wang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Gastroenterology
Subjects:
Online Access:https://doi.org/10.1186/s12876-025-04006-7
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850243297987002368
author Jianjun Wang
Wei He
Xianfu Cai
Zhaohui Hu
Yonghai Peng
Xi Chen
Pei Yang
Xintao Zeng
Sirui Chen
Decai Wang
author_facet Jianjun Wang
Wei He
Xianfu Cai
Zhaohui Hu
Yonghai Peng
Xi Chen
Pei Yang
Xintao Zeng
Sirui Chen
Decai Wang
author_sort Jianjun Wang
collection DOAJ
description Abstract Background Relative fat mass (RFM) is a novel, easily calculated, and cost-effective index of fat content and distribution in the body, associated with the odds of developing various obesity-related diseases. However, its association with metabolic dysfunction associated steatotic liver disease (MASLD) and severe hepatic steatosis (SHS) is underexplored. This study aims to examine the relationship between RFM and the odds of having MASLD or SHS in the general adult population. Methods This was a population-based cross-sectional study using data from the National Health and Nutrition Examination Survey (2017.01–2020.03). The aim of the statistical analysis was to examine the association between RFM and the prevalence of MASLD and SHS. Logistic regression was applied to explore this relationship. Nonlinear associations between RFM levels and MASLD or SHS prevalence were assessed using smoothed curve fitting and threshold effect models. Subgroup analyses were conducted to evaluate the consistency of this association across different population groups. Results A total of 6699 participants were included in this study, of whom 2825 had MASLD and 1834 had SHS. After adjusting for confounders, significant positive associations were observed between RFM and the prevalence of MASLD and SHS (odds ratio [OR]: 1.22, 95% confidence interval [CI: ] 1.18–1.26 and OR: 1.26, 95% CI: 1.21–1.30). Smoothed curve fitting and threshold effect analysis showed a nonlinear relationship between RFM and the prevalence of MASLD and SHS, with thresholds of 41.96 for MASLD prevalence and 40.42 for SHS prevalence. When the subgroups were analyzed according to sex, age, race, education level, smoking status, household income, body mass index, hypertension, and diabetes, no significant interactions were found between RFM and most subgroups. Conclusions Our results demonstrated a positive nonlinear relationship between RFM and the prevalence of MASLD and SHS, with a threshold effect. Lower RFM levels are associated with lower odds of MASLD and SHS. These findings suggest that RFM may serve as a simple, cost-effective tool for identifying individuals at increased odds of NAFLD and SHS in the general population.
format Article
id doaj-art-4f0aacd8d0354c19aa5584d6dfefbd79
institution OA Journals
issn 1471-230X
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series BMC Gastroenterology
spelling doaj-art-4f0aacd8d0354c19aa5584d6dfefbd792025-08-20T02:00:01ZengBMCBMC Gastroenterology1471-230X2025-05-0125111310.1186/s12876-025-04006-7Relative fat mass and risk of metabolic dysfunction associated steatotic liver disease and severe hepatic steatosis in U.S. adults: analysis of NHANES 2017–2020 dataJianjun Wang0Wei He1Xianfu Cai2Zhaohui Hu3Yonghai Peng4Xi Chen5Pei Yang6Xintao Zeng7Sirui Chen8Decai Wang9Department of Hepatobiliary Surgery, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Stomatology, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Urology, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Hepatobiliary Surgery, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Hepatobiliary Surgery, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Hepatobiliary Surgery, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Hepatobiliary Surgery, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Hepatobiliary Surgery, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of ChinaDepartment of Hepatobiliary Surgery, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of ChinaNHC Key Laboratory of Nuclear Technology Medical Transformation, School of Medicine, Mianyang Central Hospital, University of Electronic Science and Technology of ChinaAbstract Background Relative fat mass (RFM) is a novel, easily calculated, and cost-effective index of fat content and distribution in the body, associated with the odds of developing various obesity-related diseases. However, its association with metabolic dysfunction associated steatotic liver disease (MASLD) and severe hepatic steatosis (SHS) is underexplored. This study aims to examine the relationship between RFM and the odds of having MASLD or SHS in the general adult population. Methods This was a population-based cross-sectional study using data from the National Health and Nutrition Examination Survey (2017.01–2020.03). The aim of the statistical analysis was to examine the association between RFM and the prevalence of MASLD and SHS. Logistic regression was applied to explore this relationship. Nonlinear associations between RFM levels and MASLD or SHS prevalence were assessed using smoothed curve fitting and threshold effect models. Subgroup analyses were conducted to evaluate the consistency of this association across different population groups. Results A total of 6699 participants were included in this study, of whom 2825 had MASLD and 1834 had SHS. After adjusting for confounders, significant positive associations were observed between RFM and the prevalence of MASLD and SHS (odds ratio [OR]: 1.22, 95% confidence interval [CI: ] 1.18–1.26 and OR: 1.26, 95% CI: 1.21–1.30). Smoothed curve fitting and threshold effect analysis showed a nonlinear relationship between RFM and the prevalence of MASLD and SHS, with thresholds of 41.96 for MASLD prevalence and 40.42 for SHS prevalence. When the subgroups were analyzed according to sex, age, race, education level, smoking status, household income, body mass index, hypertension, and diabetes, no significant interactions were found between RFM and most subgroups. Conclusions Our results demonstrated a positive nonlinear relationship between RFM and the prevalence of MASLD and SHS, with a threshold effect. Lower RFM levels are associated with lower odds of MASLD and SHS. These findings suggest that RFM may serve as a simple, cost-effective tool for identifying individuals at increased odds of NAFLD and SHS in the general population.https://doi.org/10.1186/s12876-025-04006-7Nonalcoholic fatty liver diseaseSevere hepatic steatosisRelative fat massMetabolic syndromeObesityCross-sectional study
spellingShingle Jianjun Wang
Wei He
Xianfu Cai
Zhaohui Hu
Yonghai Peng
Xi Chen
Pei Yang
Xintao Zeng
Sirui Chen
Decai Wang
Relative fat mass and risk of metabolic dysfunction associated steatotic liver disease and severe hepatic steatosis in U.S. adults: analysis of NHANES 2017–2020 data
BMC Gastroenterology
Nonalcoholic fatty liver disease
Severe hepatic steatosis
Relative fat mass
Metabolic syndrome
Obesity
Cross-sectional study
title Relative fat mass and risk of metabolic dysfunction associated steatotic liver disease and severe hepatic steatosis in U.S. adults: analysis of NHANES 2017–2020 data
title_full Relative fat mass and risk of metabolic dysfunction associated steatotic liver disease and severe hepatic steatosis in U.S. adults: analysis of NHANES 2017–2020 data
title_fullStr Relative fat mass and risk of metabolic dysfunction associated steatotic liver disease and severe hepatic steatosis in U.S. adults: analysis of NHANES 2017–2020 data
title_full_unstemmed Relative fat mass and risk of metabolic dysfunction associated steatotic liver disease and severe hepatic steatosis in U.S. adults: analysis of NHANES 2017–2020 data
title_short Relative fat mass and risk of metabolic dysfunction associated steatotic liver disease and severe hepatic steatosis in U.S. adults: analysis of NHANES 2017–2020 data
title_sort relative fat mass and risk of metabolic dysfunction associated steatotic liver disease and severe hepatic steatosis in u s adults analysis of nhanes 2017 2020 data
topic Nonalcoholic fatty liver disease
Severe hepatic steatosis
Relative fat mass
Metabolic syndrome
Obesity
Cross-sectional study
url https://doi.org/10.1186/s12876-025-04006-7
work_keys_str_mv AT jianjunwang relativefatmassandriskofmetabolicdysfunctionassociatedsteatoticliverdiseaseandseverehepaticsteatosisinusadultsanalysisofnhanes20172020data
AT weihe relativefatmassandriskofmetabolicdysfunctionassociatedsteatoticliverdiseaseandseverehepaticsteatosisinusadultsanalysisofnhanes20172020data
AT xianfucai relativefatmassandriskofmetabolicdysfunctionassociatedsteatoticliverdiseaseandseverehepaticsteatosisinusadultsanalysisofnhanes20172020data
AT zhaohuihu relativefatmassandriskofmetabolicdysfunctionassociatedsteatoticliverdiseaseandseverehepaticsteatosisinusadultsanalysisofnhanes20172020data
AT yonghaipeng relativefatmassandriskofmetabolicdysfunctionassociatedsteatoticliverdiseaseandseverehepaticsteatosisinusadultsanalysisofnhanes20172020data
AT xichen relativefatmassandriskofmetabolicdysfunctionassociatedsteatoticliverdiseaseandseverehepaticsteatosisinusadultsanalysisofnhanes20172020data
AT peiyang relativefatmassandriskofmetabolicdysfunctionassociatedsteatoticliverdiseaseandseverehepaticsteatosisinusadultsanalysisofnhanes20172020data
AT xintaozeng relativefatmassandriskofmetabolicdysfunctionassociatedsteatoticliverdiseaseandseverehepaticsteatosisinusadultsanalysisofnhanes20172020data
AT siruichen relativefatmassandriskofmetabolicdysfunctionassociatedsteatoticliverdiseaseandseverehepaticsteatosisinusadultsanalysisofnhanes20172020data
AT decaiwang relativefatmassandriskofmetabolicdysfunctionassociatedsteatoticliverdiseaseandseverehepaticsteatosisinusadultsanalysisofnhanes20172020data