Study on the association between the waist-to-arm ratio and both metabolic dysfunction-associated steatotic liver disease and hepatic fibrosis in older adults

CHEN Zhaoguang; YU Jianfeng; WANG Yanbin; ZHANG Donglei; HAO Jianyu; LIU Xinjuan

doi:10.3969/j.issn.1004-3594.2026.06.004

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Medical Journal of the Chinese People Armed Police Forces ›› 2026, Vol. 37 ›› Issue (6) : 477-483. DOI: 10.3969/j.issn.1004-3594.2026.06.004

ORIGINAL ARTICLES

Study on the association between the waist-to-arm ratio and both metabolic dysfunction-associated steatotic liver disease and hepatic fibrosis in older adults

CHEN Zhaoguang, YU Jianfeng, WANG Yanbin, ZHANG Donglei, HAO Jianyu, LIU Xinjuan

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Abstract

Objective To explore the potential association between the waist-to-arm ratio(WAR) and both metabolic dysfunction-associated steatotic liver disease (MASLD) and hepatic fibrosis in older adults. Methods A total of 60-year-old and above elderly individuals from the National Health and Nutrition Examination Survey (NHANES) database from 2017 to 2020 were selected. WAR was used as the exposure variable and was categorized according to quartiles to assess its association with MASLD and hepatic fibrosis. Multivariable logistic regression model was used to estimate the relationship between WAR and the risk of MASLD and hepatic fibrosis, and subgroup analyses, interaction tests and restricted cubic spline analysis were performed to assess the non-linear association. Results A total of 2,084 participants were included in the study. The prevalence of MASLD was 42.7%, and that of hepatic fibrosis was 14.3%. WAR was divided into quartiles (Q1-Q4), each comprising 521 individuals. Multivariable logistic regression revealed a significant, positive association between higher WAR and the risk of MASLD (fully adjusted model OR=2.51; 95% CI, 1.69-3.72; P<0.001) , and the risk of MASLD in the Q4 group was 1.12 times higher than that in the Q1 group (OR=2.12; 95% CI, 1.56-2.88; P<0.001). Similarly, an increase in WAR was also significantly positively associated with the risk of hepatic fibrosis (fully adjusted model OR=2.35; 95% CI, 1.45-3.83; P=0.001), and the risk of hepatic fibrosis in the Q4 group was 1.11 times higher than that in the Q1 group (OR=2.11; 95% CI, 1.37-3.24; P=0.001). Subgroup analyses confirmed the consistency of these associations across all subgroups. Restricted cubic spline(RCS) regression indicated linear relationship between WAR and both MASLD and hepatic fibrosis (non-linearity P>0.05). Conclusions In older adults, WAR is significantly positively associated with the risk of MASLD and hepatic fibrosis.

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metabolic dysfunction-associated steatotic liver disease / waist-to-arm ratio / hepatic fibrosis / health and nutrition survey

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CHEN Zhaoguang, YU Jianfeng, WANG Yanbin, ZHANG Donglei, HAO Jianyu, LIU Xinjuan. Study on the association between the waist-to-arm ratio and both metabolic dysfunction-associated steatotic liver disease and hepatic fibrosis in older adults[J]. Medical Journal of the Chinese People Armed Police Forces. 2026, 37(6): 477-483 https://doi.org/10.3969/j.issn.1004-3594.2026.06.004

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