Waist circumference associates with ultrasound-defined steatosis grade in NAFLD patients characterized by uniformly suboptimal diet
Obesity Medicine, cilt.62, 2026 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 62
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.obmed.2026.100728
- Dergi Adı: Obesity Medicine
- Derginin Tarandığı İndeksler: Scopus
- Anahtar Kelimeler: Diet quality, Dietary inflammatory index, Non alcoholic fatty liver, Plant based diet, Waist circumference
- Ankara Üniversitesi Adresli: Evet
Özet
Background Non-alcoholic fatty liver disease (NAFLD) clinical phenotypes involve complex interactions between adiposity and diet. A particularly underexplored question is whether dietary quality differs across steatosis severity grades in clinically complex, high-risk cohorts with prevalent T2DM. We hypothesized that specific dietary patterns would be associated with disease severity, independent of anthropometric indices. Methods In this cross-sectional study, 160 adults with confirmed NAFLD were evaluated using structured questionnaires, anthropometric measurements, and a 108-item food frequency questionnaire. Steatosis severity (Grades 1–3) was determined by ultrasonography. Healthy Eating Index-2015 (HEI-2015), Dietary Inflammatory Index (DII), Potential Renal Acid Load (PRAL), and Plant-Based Diet Index (PDI) were computed. Hierarchical binary logistic regression was performed using complete-case analysis (n = 122), adjusting for sex, type 2 diabetes, and total energy intake. Results Body weight, BMI, and waist circumference increased significantly across steatosis grades (p < 0.001). No significant differences were observed in HEI-2015, DII, PRAL, or PDI across groups (p > 0.05), and none showed independent associations with steatosis grade in adjusted models. Dietary quality was uniformly suboptimal across all severity grades. Waist circumference was consistently associated with higher ultrasound-assigned steatosis grades across all models in this selected cohort (OR: 1.10, 95% CI: 1.05–1.16, p < 0.001), accounting for 27% of the variance explained by the base logistic model. Conclusion A key finding is that dietary quality was uniformly suboptimal across all steatosis severity grades, including the mildest stage, supporting consideration of nutritional assessment and intervention from early disease stages regardless of disease severity. In this highly selected clinical cohort with a high burden of metabolic comorbidities, waist circumference demonstrated a consistent independent association with ultrasound-defined steatosis grade. These findings should not be generalized beyond this specific metabolic phenotype.