Endocrine Abstracts

Introduction: Overweight is a major prognostic factor in metabolic steatopathy. The Waist-to-Height Ratio (WHtR) has recently been introduced as a clinical marker predictive of cardiovascular complications related to obesity. The objective of our study was to evaluate the performance of this ratio in detecting complications related to metabolic steatopathy (Liver fibrosis and cardiovascular risk).

Patients and Methods: This was a prospective, cross-sectional, descriptive study including all patients with metabolic steatopathy who consulted between March 2021 and December 2022. Age, medical history, and various lifestyle habits were collected. Anthropometric measurements and blood pressure were taken. Body mass index (BMI) and the WHtR were calculated. Liver fibrosis was assessed using transient elastography (Fibroscan), with advanced liver fibrosis defined in this study as elasticity ≥ 9.7 kPa. Cardiovascular risk assessment was done using the GLOBORISK score, a validated tool for evaluating 10-year cardiovascular mortality. High cardiovascular risk was defined by a GLOBORISK score ≥ 20%.

Results: The study population included 107 patients with a mean age of 54.5±10.1 years and a gender-ratio of 0.53. History of hypertension, type 2 diabetes, and dyslipidemia were noted in 44.9%, 43%, and 31.8% of patients, respectively. Smoking and alcohol use were noted in 11.2% and 8.4%, respectively. The mean BMI was 30.56±5.7 kg/m², and the mean WHtR was 0.61±0.08. Advanced liver fibrosis was found in 14% of patients. We observed a high cardiovascular risk in 35.5% of patients. The WHtR showed better performance than BMI in identifying patients at risk of advanced fibrosis, with respective areas under the ROC curve of 0.729 (95% CI 0.615 –0.843) and 0.7 (95% CI 0.577 –0.839). The cutoff for the WHtR in identifying patients at risk of advanced fibrosis was 0.6, with a sensitivity of 93% and specificity of 50%. In terms of high cardiovascular risk, the WHtR showed slightly better performance than BMI, with areas under the ROC curve of 0.65 (95% CI 0.53 –0.752) and 0.61 (95% CI 0.505 - 0.731), respectively. The cutoff for this ratio in predicting high cardiovascular risk was also 0.6, with a sensitivity of 65% and specificity of 42%.

Conclusion: The WHtR is a simple tool that better represents the impact of obesity on the prognosis of metabolic steatopathy, both in terms of liver fibrosis and cardiovascular risk.