This study aimed to determine whether the waist-to-thigh ratio (WTTR) is associated with the incidence of metabolic-associated fatty liver disease (MAFLD) in health care workers. There were 4517 health care workers with baseline data and results from 2 follow-up examinations. We divided the subjects into 3 groups according to baseline WTTR and used the Cox hazard regression model to estimate MAFLD risk. The WTTRs were categorized by tertiles at baseline using the values 1.58 and 1.66. Patients with higher WTTR tended to have significantly greater values for the following factors, body mass index (BMI), fasting blood glucose (FPG), systolic blood pressure, diastolic blood pressure, total cholesterol (TC), triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C) and neck circumference. The incidence of MAFLD significantly increased with increasing WTTR tertiles (5.74%, 12.75% and 22.25% for the first, second and third tertiles, respectively, P < 0.05 for trend). Kaplan-Meier(K-M) survival analysis revealed a significant tendency towards increased MAFLD risk with increasing WTTR tertile. In the fully adjusted model, the hazard ratios (95% CIs) for MAFLD in the second, third WTTR tertiles compared with the first quartile were 2.17(1.58,2.98), 3.63(2.70,4.89), respectively, third neck circumference tertiles compared with the first quartile were 2.84(1.89,4.25), 8.95(6.00,13.35), respectively. Compared with those of individuals with a BMI > 23 kg/m2, the associations between WTTR and MAFLD incidence were more pronounced in subjects with a BMI < 23 kg/m2. Similarly, the difference in neck circumference was more pronounced in these patients with a BMI < 23 kg/m2. Our results revealed that the WTTR is an independent risk factor for MAFLD, and there was a dose‒response relationship between the WTTR and MAFLD risk. The neck circumference was significantly different in subjects with a BMI < 23 kg/m2. This approach provides a new way to predict the incidence rate of MAFLD.

中文翻译：

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腰围与大腿围比作为 MAFLD 的预测因子：一项具有 2 年随访的医护人员研究

本研究旨在确定医护人员的腰围与大腿比 (WTTR) 是否与代谢相关脂肪肝 (MAFLD) 的发病率相关。有 4517 名卫生保健工作者拥有基线数据和 2 次随访检查的结果。我们根据基线 WTTR 将受试者分为 3 组，并使用 Cox 风险回归模型来估计 MAFLD 风险。 WTTR 使用值 1.58 和 1.66 在基线上按三分位数进行分类。 WTTR 较高的患者往往在以下因素方面具有显着较高的值：体重指数 (BMI)、空腹血糖 (FPG)、收缩压、舒张压、总胆固醇 (TC)、甘油三酯 (TG)、低血压密度脂蛋白胆固醇（LDL-C）和颈围。随着WTTR三分位数的增加，MAFLD的发生率显着增加（第一、第二和第三三分位数分别为5.74%、12.75%和22.25%，趋势P < 0.05）。 Kaplan-Meier (KM) 生存分析显示，随着 WTTR 三分位数的增加，MAFLD 风险显着增加。在完全调整的模型中，与第一四分位数相比，第二、第三 WTTR 三分位数中 MAFLD 的风险比（95% CI）分别为 2.17（1.58，2.98）、3.63（2.70，4.89），第三颈围三分位数相比与第一个四分位数分别为2.84（1.89，4.25），8.95（6.00，13.35）。与 BMI > 23 kg/m2 的个体相比，BMI < 23 kg/m2 的受试者中 WTTR 和 MAFLD 发病率之间的关联更为明显。同样，BMI < 23 kg/m2 的患者颈围差异更为明显。我们的结果显示，WTTR 是 MAFLD 的独立危险因素，并且 WTTR 与 MAFLD 风险之间存在剂量反应关系。 BMI < 23 kg/m2 的受试者的颈围存在显着差异。该方法为预测MAFLD的发病率提供了一种新方法。