Related Experiment Video
Updated: Apr 14, 2026
Optimized Analysis of In Vivo and In Vitro Hepatic Steatosis
Published on: March 11, 2017
Comparative performance of multiple novel obesity indices for MAFLD screening in Chinese children: the body roundness
Minhao Fan1, Cai Tang1, Shibo Lin2
1Wuxi Key Laboratory of Genetic and Metabolic Diseases in Children, Department of Paediatrics, Wuxi Children's Hospital, Affiliated Children's Hospital of Jiangnan University, Wuxi, Jiangsu, China.
Insights
Four novel obesity indices, including body roundness index (BRI), are linked to pediatric metabolic dysfunction-associated fatty liver disease (MAFLD). BRI shows promise as a simple, effective screening tool for early MAFLD risk identification in children.
Area of Science:
- Pediatric Endocrinology
- Hepatology
- Public Health Nutrition
Background:
- Childhood obesity rates are rising globally, leading to an increase in metabolic dysfunction-associated fatty liver disease (MAFLD).
- Traditional obesity metrics may not fully capture the complexity of metabolic risk in children.
- Novel obesity indices offer potential for improved risk assessment.
Purpose of the Study:
- To investigate the association between four novel obesity indices (VAI, LAP, BRI, WWI) and pediatric MAFLD.
- To compare the screening performance of these novel indices against traditional measures for MAFLD in children.
Main Methods:
- Utilized data from the Wuxi (China) Children's Nutrition and Health cohort (n=1,214).
- Employed logistic regression and restricted cubic splines (RCS) to analyze associations.
- Used ROC curve analysis and DeLong's test to compare the predictive performance of BRI against BMI, WC, and WHtR.
Main Results:
- All four novel obesity indices (VAI, LAP, BRI, WWI) were significantly associated with pediatric MAFLD (p < 0.001).
- The body roundness index (BRI) demonstrated high and consistent screening performance across subgroups.
- BRI's predictive performance was comparable to BMI and WHtR, and superior to WC in certain subgroups.
Conclusions:
- Novel obesity indices, particularly BRI, are significantly associated with MAFLD in children.
- BRI is a simple, reliable, and clinically useful tool for screening and early risk stratification of pediatric MAFLD.
- These findings support the integration of BRI into routine pediatric health assessments for MAFLD risk identification.
Abstract:
In recent years, as childhood obesity rates soar globally, there has been a concomitant increase in the prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD). The intent of this analysis is to explore the correlation between four novel obesity indices and pediatric MAFLD, and to compare their varying screening performance for MAFLD. We used data from the Wuxi (China) Children's Nutrition and Health cohort. Logistic regression and restricted cubic spline (RCS) were employed to assess the associations between the obesity indices, including visceral adiposity index (VAI), lipid accumulation product (LAP), body roundness index (BRI), and weight-adjusted waist index (WWI) with MAFLD in children. Furthermore, Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive performance of the four novel obesity indices, and DeLong's test was applied to compare the AUC of the best-performing index (BRI) with those of traditional anthropometric measures (BMI, WC, and WHtR). A total of 1,214 children (aged 6-14 years) were enrolled in this study, with a mean age of 10.3 years and a boy proportion of 56.4%. Among them, 205 (16.8%) were diagnosed with MAFLD, while the remaining 1,009 (83.1%) served as controls. The multivariate logistic regression revealed that the VAI, LAP, BRI and WWI displayed a marked association with MAFLD in children (all p < 0.001). Among them, BRI exhibited high and consistent screening performance for pediatric MAFLD across all analyzed subgroups. For instance, in the subgroup with CAP ≥ 248 dB/m, it achieved an AUC of 0.929 (95% CI: 0.913-0.945), comparable to traditional BMI and WHtR, and significantly outperformed WC. Our findings demonstrated four the novel obesity indices are significantly associated with MAFLD in children. The BRI emerges as a simple, reliable, and clinically useful screening tool that captures visceral fat distribution and may aid in early risk stratification.
