REN Yan, QIU Linjie, LI Jixin, LI Meijie, ZOU Chacha, WU Zijing, ZHANG Jin
Medical Journal of the Chinese People Armed Police Forces. 2026, 37(2): 98-105.
Objective To explore the correlation between arm circumference (AC), arm -to-height ratio (AHtR), arm-to-thigh ratio(ATR), and arm--muscle ratio (AMR) and non-overweight/obese individuals with non-alcoholic fatty liver disease (NAFLD), as well as their predictive value. Methods A total of 1,472 non-overweight/obese adults who underwent health check-ups at Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 2018 to September 2024 were included. Baseline levels were compared based on whether they had NAFLD. EmpowerRCH 4.1, was used to analyze the relationships between AC, AHtR, ATR, AMR and the prevalence and the hepatic steatosis index (HSI) of NAFLD in non-overweight/obese individuals. To assess the robustness of the research results, subgroup analyses were conducted based on gender, age, smoking status, and presence of hypertension and diabetes. Receiver-operating-characteristic (ROC) curve was used to evaluate the diagnostic efficacy of AC, AHtR, ATR, and AMR for NAFLD in non-overweight/obese individuals. Results A total of 1472 eligible check-up records were included in this study. After adjustment for age, sex, diabetes and hypertension, each 1-unit increase in AC, ATR and AHtR was associated with 91%, 24% and 72% higher odds of NAFLD, respectively, and with increments of 1.08, 0.33 and 1.47 units in HSI. Conversely, every 1-unit increase in AMR reduced the odds of NAFLD by 49% and lowered HSI by 0.56 units. The areas under the ROC curve (AUC) for AC, AHtR, ATR, and AMR were 0.793, 0.688, 0.656 and 0.636, respectively, and there were statistically significant differences between them (P<0.05). Conclusions In non-overweight/obese individuals, AC, ATR, AHtR and AMR exhibit significant nonlinear positive associations, whereas AMR shows a significant non-linear inverse association with both NAFLD prevalence and HSI level, while AMR shows significant nonlinear negative correlations with the prevalence and HSI levels of NAFLD. AC, AHtR, ATR and AMR can all serve as early diagnosis of NAFLD in non-overweight/obese individuals, and AMR has better diagnostic efficacy.