Endocrine Abstracts

Background/Objectives: Although it has been well-established that menopause causes a shift in body fat, thereby eliciting metabolic disturbances in women, there has been no study conducted yet to examine the best obesity parameters to predict the risk of nonalcoholic fatty liver disease (NAFLD) in this population. Thus, the aim of this study was to compare the efficacy of body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) for screening NAFLD according to menopausal status.

Subjects/Methods: This cross-sectional analysis included 620 healthy women between 20 years and 80 years of age recruited from the Health Promotion Center of Korea University Guro Hospital. NAFLD was diagnosed by abdominal ultrasonography.

Results: All receiver operating characteristic curves of BMI, WC, and WHR for NAFLD were established statistically above the diagonal nondiscrimination line. In premenopausal women, there were no statistical differences in area under the curve (AUC) values among the three obesity indices, whereas, in postmenopausal women, the AUC value of WHR was significantly larger than those of either BMI (P=0.005) or WC (P=0.007). Furthermore, in postmenopausal women, the combination of WHR with BMI or WC significantly increased predictive power of NAFLD when compared to using BMI or WC alone. The optimal cutoff values for BMI, WC, and WHR for detecting NAFLD were 23.9 kg/m², 69 cm, and 0.81 in premenopausal women and 22.9 kg/m², 74 cm, and 0.86 in postmenopausal women, respectively.

Conclusion: In premenopausal women, BMI, WC, and WHR hold similar potential in predicting the risk of NAFLD, whereas, in postmenopausal women, WHR is the most useful discriminative indicator for NAFLD. Women’s optimal cutoff values for NAFLD were different according to menopausal status.