{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:45:18Z","timestamp":1771922718847,"version":"3.50.1"},"reference-count":77,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify the optimal surrogate indicator for the initial public health screening of non-alcoholic fatty liver disease (NAFLD) among U.S. adults aged 60 years and above, by systematically comparing the predictive performance of a novel index\u2014the triglyceride glucose-waist-to-height ratio (TyGWHtR)\u2014against 15 other conventional obesity, metabolic, and inflammatory indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study included 1,634 participants from the National Health and Nutrition Examination Survey (2017-March 2020). This study included 16 indicators: weight, waist-to-height ratio (WHtR), body mass index (BMI), waist circumference (WC), weight-adjusted-waist index (WWI), triglyceride glucose (TyG), TyGBMI, TyGWHtR, TyGWWI, TyGWC, TyGWeight, cardiometabolic index (CMI), systemic inflammatory response index (SIRI), systemic immune inflammation index (SII), visceral adiposity index (VAI), and lipid accumulation product (LAP). The participants were categorized into a non-NAFLD group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f945) and an NAFLD group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f689). The associations between 16 potential indicators and NAFLD, as defined by FibroScan\u00ae, were evaluated using weighted multivariable logistic regression. Indicators that displayed significant associations were further analyzed using receiver operating characteristic (ROC) curves. To investigate a dose-response relationship, we employed restricted cubic splines. Additionally, subgroup and sensitivity analyses were conducted to assess the robustness of the findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>Five indicators (WHtR, TyG, TyGWHtR, WWI, and CMI) showed significant positive associations with NAFLD. Among these, TyGWHtR demonstrated the best predictive performance [area under the curve (AUC): 0.7641; 95% CI: 0.7414\u20130.7869], with a nonlinear dose-response relationship. The association remained robust across all subgroups and sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The TyGWHtR index is a simple, low-cost, and effective single indicator that outperforms multiple conventional indices for identifying older U.S. adults at high risk of NAFLD. Its reliance on routinely measured clinical parameters makes it an efficient tool for initial risk stratification in community and public health settings, facilitating targeted prevention and supporting healthy aging initiatives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1569324","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T05:37:10Z","timestamp":1768973830000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The association between triglyceride glucose-waist-to-height ratio and non-alcoholic fatty liver disease in adults aged over 60 in the United States: a cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Lixian","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, The First Hospital of Putian City","place":["Putian, Fujian, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guoyan","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Hospital of Putian City","place":["Putian, Fujian, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lijun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Hospital of Putian City","place":["Putian, Fujian, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junwei","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Hospital of Putian City","place":["Putian, Fujian, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s40520-025-03021-8","article-title":"Aging, longevity, and healthy aging: the public health approach","volume":"37","author":"Gianfredi","year":"2025","journal-title":"Aging clinical and experimental research"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1038\/s41392-022-01251-0","article-title":"Aging and aging-related diseases: from molecular mechanisms to interventions and treatments","volume":"7","author":"Guo","year":"2022","journal-title":"Signal transduction and targeted therapy"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1055","DOI":"10.1183\/09031936.00059814","article-title":"Ageing and the epidemiology of multimorbidity","volume":"44","author":"Divo","year":"2014","journal-title":"The European respiratory journal"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1093\/eurpub\/12.1.57","article-title":"Age-specific increases in health care costs","volume":"12","author":"Polder","year":"2002","journal-title":"European journal of public health"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"112334","DOI":"10.1016\/j.exger.2023.112334","article-title":"Old age as a risk factor for liver diseases: Modern therapeutic approaches","volume":"184","author":"Georgieva","year":"2023","journal-title":"Experimental gerontology"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1797","DOI":"10.1097\/HEP.0000000000000323","article-title":"AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease","volume":"77","author":"Rinella","year":"2023","journal-title":"Hepatology"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1016\/S2468-1253(22)00165-0","article-title":"The prevalence and incidence of NAFLD worldwide: a systematic review and meta-analysis","volume":"7","author":"Riazi","year":"2022","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1016\/j.eprac.2022.03.010","article-title":"American Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings: Co-Sponsored by the American Association for the Study of Liver Diseases (AASLD)","volume":"28","author":"Cusi","year":"2022","journal-title":"Endocr Pract"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"119","DOI":"10.21037\/hbsn-23-556","article-title":"The global burden of fatty liver disease: the major impact of China","volume":"13","author":"Lou","year":"2024","journal-title":"Hepatobiliary Surg Nutr"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1097\/HEP.0000000000000004","article-title":"The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review","volume":"77","author":"Younossi","year":"2023","journal-title":"Hepatology"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"962","DOI":"10.1136\/gutjnl-2020-322572","article-title":"Non-alcoholic fatty liver disease and risk of incident diabetes mellitus: an updated meta-analysis of 501 022 adult individuals","volume":"70","author":"Mantovani","year":"2021","journal-title":"Gut"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e168","DOI":"10.1161\/ATV.0000000000000153","article-title":"Nonalcoholic Fatty Liver Disease and Cardiovascular Risk: A Scientific Statement From the American Heart Association","volume":"42","author":"Duell","year":"2022","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"386","DOI":"10.21037\/hbsn-22-421","article-title":"An international Delphi consensus statement on metabolic dysfunction-associated fatty liver disease and risk of chronic kidney disease","volume":"12","author":"Sun","year":"2023","journal-title":"Hepatobiliary Surg Nutr"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1016\/j.ejca.2022.06.051","article-title":"Hepatocellular and extrahepatic cancers in non-alcoholic fatty liver disease: A systematic review and meta-analysis","volume":"173","author":"Thomas","year":"2022","journal-title":"Eur J Cancer"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1038\/s41575-020-00381-6","article-title":"Global epidemiology of NAFLD-related HCC: trends, predictions, risk factors and prevention","volume":"18","author":"Huang","year":"2021","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1577","DOI":"10.1002\/hep.28785","article-title":"The economic and clinical burden of nonalcoholic fatty liver disease in the United States and Europe","volume":"64","author":"Younossi","year":"2016","journal-title":"Hepatology"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1002\/cld.81","article-title":"Nonalcoholic fatty liver disease: Definitions, risk factors, and workup","volume":"1","author":"Puri","year":"2012","journal-title":"Clin Liver Dis (Hoboken)"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.3892\/etm.2011.328","article-title":"Effects of insulin resistance and hepatic lipid accumulation on hepatic mRNA expression levels of apoB, MTP and L-FABP in non-alcoholic fatty liver disease","volume":"2","author":"Higuchi","year":"2011","journal-title":"Exp Ther Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"3313","DOI":"10.1007\/s00018-018-2860-6","article-title":"Molecular mechanisms of hepatic lipid accumulation in non-alcoholic fatty liver disease","volume":"75","author":"Ipsen","year":"2018","journal-title":"Cell Mol Life Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1111\/liv.13301","article-title":"Pathology of non-alcoholic fatty liver disease","volume":"37","author":"Bedossa","year":"2017","journal-title":"Liver Int"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1264","DOI":"10.1053\/j.gastro.2018.12.036","article-title":"Noninvasive Assessment of Liver Disease in Patients With Nonalcoholic Fatty Liver Disease","volume":"156","author":"Castera","year":"2019","journal-title":"Gastroenterology"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1111\/j.1440-1746.2007.05002.x","article-title":"Guidelines for the assessment and management of non-alcoholic fatty liver disease in the Asia-Pacific region: executive summary","volume":"22","author":"Farrell","year":"2007","journal-title":"J Gastroenterol Hepatol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1111\/j.1751-2980.2008.00331.x","article-title":"Guidelines for the diagnosis and treatment of nonalcoholic fatty liver diseases","volume":"9","author":"Zeng","year":"2008","journal-title":"J Dig Dis"},{"key":"ref24","volume-title":"Non-Alcoholic Fatty Liver Disease: Assessment and Management","year":"2016"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1186\/s12889-015-1471-5","article-title":"Anthropometric indices as predictors of hypertension among men and women aged 40-69 years in the Korean population: the Korean Genome and Epidemiology Study","volume":"15","author":"Lee","year":"2015","journal-title":"BMC Public Health"},{"key":"ref26","first-page":"1083032","volume-title":"Front Endocrinol (Lausanne)","author":"Peng","year":"2023"},{"key":"ref27","first-page":"84151","article-title":"Healing from Within: How Gut Microbiota Predicts IBD Treatment Success-A Systematic Review","volume-title":"Int J Mol Sci","author":"Alexandrescu","year":"2024"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"2341","DOI":"10.3390\/microorganisms12112341","article-title":"Intestinal Insights: The Gut Microbiome's Role in Atherosclerotic Disease: A Narrative Review","volume":"12","author":"Alexandrescu","year":"2024","journal-title":"Microorganisms"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"2472","DOI":"10.3390\/ijms25052472","article-title":"Endotoxin Inflammatory Action on Cells by Dysregulated-Immunological-Barrier-Linked ROS-Apoptosis Mechanisms in Gut-Liver Axis","volume":"25","author":"Dumitru","year":"2024","journal-title":"Int J Mol Sci"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1323174","DOI":"10.3389\/fimmu.2024.1323174","article-title":"Association between systemic immune inflammation index, systemic inflammation response index and adult psoriasis: evidence from NHANES","volume":"15","author":"Ma","year":"2024","journal-title":"Front Immunol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"925690","DOI":"10.3389\/fimmu.2022.925690","article-title":"Association between SII and hepatic steatosis and liver fibrosis: A population-based study","volume":"13","author":"Xie","year":"2022","journal-title":"Front Immunol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1016\/j.numecd.2021.11.017","article-title":"Comparison of triglyceride-glucose index and HOMA-IR for predicting prevalence and incidence of metabolic syndrome","volume":"32","author":"Son","year":"2022","journal-title":"Nutr Metab Cardiovasc Dis"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1186\/s12933-023-02018-9","article-title":"Association between the triglyceride-glucose index and 1-year major adverse cardiovascular events in patients with coronary heart disease and hypertension","volume":"22","author":"Tao","year":"2023","journal-title":"Cardiovasc Diabetol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"969","DOI":"10.2147\/NSS.S362101","article-title":"Association Between Triglyceride Glucose Index-Waist Circumference and Risk of First Myocardial Infarction in Chinese Hypertensive Patients with Obstructive Sleep Apnoea: An Observational Cohort Study","volume":"14","author":"Hu","year":"2022","journal-title":"Nat Sci Sleep"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"403","DOI":"10.1186\/s12872-025-04853-y","article-title":"Association between triglyceride glucose-waist to height ratio (TyG-WHtR) and hypertension in adults aged 18-60: a cross-sectional study","volume":"25","author":"Huang","year":"2025","journal-title":"BMC Cardiovasc Disord"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1186\/s12944-021-01561-2","article-title":"The usefulness of obesity and lipid-related indices to predict the presence of Non-alcoholic fatty liver disease","volume":"20","author":"Sheng","year":"2021","journal-title":"Lipids Health Dis"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"2886","DOI":"10.1016\/j.jacc.2014.02.606","article-title":"2013 ACC\/AHA guideline on the assessment of cardiovascular risk","volume":"63","author":"Andrus","year":"2014","journal-title":"J Am Coll Cardiol"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1892","DOI":"10.3390\/nu15081892","article-title":"Predictive Role of Neutrophil-Percentage-to-Albumin Ratio (NPAR) in Nonalcoholic Fatty Liver Disease and Advanced Liver Fibrosis in Nondiabetic US Adults: Evidence from NHANES 2017-2018","volume":"15","author":"Liu","year":"2023","journal-title":"Nutrients"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1080\/13557858.2022.2027883","article-title":"Association of lifestyle behaviors with non-alcoholic fatty liver disease and advanced fibrosis detected by transient elastography among Hispanic\/Latinos adults in the U.S","volume":"28","author":"Heredia","year":"2023","journal-title":"Ethn Health"},{"key":"ref40","first-page":"1","article-title":"National health and nutrition examination survey: analytic guidelines, 1999-2010","volume":"161","author":"Johnson","year":"2013","journal-title":"Vital Health Stat 2"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1186\/s12872-023-03452-z","article-title":"Association between weight-adjusted-waist index and risk of cardiovascular diseases in United States adults: a cross-sectional study","volume":"23","author":"Fang","year":"2023","journal-title":"BMC Cardiovasc Disord"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1210669","DOI":"10.3389\/fpubh.2023.1210669","article-title":"The relationship between obesity associated weight-adjusted waist index and the prevalence of hypertension in US adults aged >\/=60 years: a brief report","volume":"11","author":"Wang","year":"2023","journal-title":"Front Public Health"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1016\/j.amjmed.2007.05.011","article-title":"Obesity paradox in patients with hypertension and coronary artery disease","volume":"120","author":"Uretsky","year":"2007","journal-title":"Am J Med"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1889","DOI":"10.26355\/eurrev_202303_31555","article-title":"Ethnic and sex differences in the distributions of body mass index and waist circumference among adults: a binationally representative study in South Korea and the United States","volume":"27","author":"Eum","year":"2023","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"920","DOI":"10.2337\/dc09-1825","article-title":"Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk","volume":"33","author":"Amato","year":"2010","journal-title":"Diabetes Care"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"2251","DOI":"10.3390\/biomedicines10092251","article-title":"Triglyceride Glucose-Waist Circumference (TyG-WC) Is a Reliable Marker to Predict Non-Alcoholic Fatty Liver Disease","volume":"10","author":"Song","year":"2022","journal-title":"Biomedicines"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"13194","DOI":"10.1038\/s41598-024-64034-3","article-title":"Association between the cardiometabolic index and NAFLD and fibrosis","volume":"14","author":"Yan","year":"2024","journal-title":"Sci Rep"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1186\/s40001-023-01205-4","article-title":"Association of weight-adjusted-waist index with non-alcoholic fatty liver disease and liver fibrosis: a cross-sectional study based on NHANES","volume":"28","author":"Hu","year":"2023","journal-title":"Eur J Med Res"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"6678755","DOI":"10.1155\/2021\/6678755","article-title":"Evaluation of Different Anthropometric Indicators for Screening for Nonalcoholic Fatty Liver Disease in Elderly Individuals","volume":"2021","author":"Zhang","year":"2021","journal-title":"Int J Endocrinol"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"868","DOI":"10.1038\/oby.2002.119","article-title":"Visceral adipose tissue in women: longitudinal study of the effects of fat gain, time, and race","volume":"10","author":"Lara-Castro","year":"2002","journal-title":"Obes Res"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1093\/oxfordjournals.aje.a008733","article-title":"How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups?","volume":"143","author":"Gallagher","year":"1996","journal-title":"Am J Epidemiol"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1016\/j.metabol.2015.12.012","article-title":"The multiple-hit pathogenesis of non-alcoholic fatty liver disease (NAFLD)","volume":"65","author":"Buzzetti","year":"2016","journal-title":"Metabolism"},{"key":"ref53","doi-asserted-by":"publisher","first-page":"15489","DOI":"10.3390\/ijms232415489","article-title":"Non-Alcoholic Fatty Liver Disease (NAFLD) Pathogenesis and Natural Products for Prevention and Treatment","volume":"23","author":"Guo","year":"2022","journal-title":"Int J Mol Sci"},{"key":"ref54","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1126\/science.1123965","article-title":"Defective lipolysis and altered energy metabolism in mice lacking adipose triglyceride lipase","volume":"312","author":"Haemmerle","year":"2006","journal-title":"Science"},{"key":"ref55","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1016\/j.cell.2012.02.017","article-title":"Mechanisms for insulin resistance: common threads and missing links","volume":"148","author":"Samuel","year":"2012","journal-title":"Cell"},{"key":"ref56","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s12933-023-02115-9","article-title":"The association between triglyceride-glucose index and its combination with obesity indicators and cardiovascular disease: NHANES 2003-2018","volume":"23","author":"Dang","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"ref57","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s12933-025-02642-7","article-title":"Association between triglyceride-glucose related indices and all-cause and cardiovascular mortality among the population with cardiovascular-kidney-metabolic syndrome stage 0-3: a cohort study","volume":"24","author":"Zhang","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"ref58","doi-asserted-by":"publisher","first-page":"10901","DOI":"10.1038\/s41598-024-61592-4","article-title":"Optimal obesity- and lipid-related indices for predicting type 2 diabetes in middle-aged and elderly Chinese","volume":"14","author":"Zhang","year":"2024","journal-title":"Sci Rep"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1325557","DOI":"10.3389\/fimmu.2023.1325557","article-title":"Positive association between different triglyceride glucose index-related indicators and psoriasis: evidence from NHANES","volume":"14","author":"Huang","year":"2023","journal-title":"Front Immunol"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1186\/s12933-024-02354-4","article-title":"Association of triglyceride glucose-related parameters with all-cause mortality and cardiovascular disease in NAFLD patients: NHANES 1999-2018","volume":"23","author":"Zhang","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"154028","DOI":"10.1016\/j.metabol.2019.154028","article-title":"Adiponectin and leptin in the diagnosis and therapy of NAFLD","volume":"103","author":"Boutari","year":"2020","journal-title":"Metabolism"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"77","DOI":"10.3350\/cmh.2022.0237","article-title":"Pathogenesis and treatment of non-alcoholic steatohepatitis and its fibrosis","volume":"29","author":"Lee","year":"2023","journal-title":"Clin Mol Hepatol"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1080\/03602532.2017.1293683","article-title":"Non-alcoholic fatty liver disease (NAFLD) - pathogenesis, classification, and effect on drug metabolizing enzymes and transporters","volume":"49","author":"Cobbina","year":"2017","journal-title":"Drug Metab Rev"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1089\/met.2023.0054","article-title":"The triglycerides-glucose index shows a stronger correlation with serum adiponectin levels than homeostasis model assessment of insulin resistance and quantitative insulin sensitivity check index","volume":"21","author":"Sendur","year":"2023","journal-title":"Metab Syndr Relat Disord"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"e220353","DOI":"10.20945\/2359-4292-2022-0353","article-title":"Association between plasma leptin\/adiponectin ratio and insulin resistance indexes in prepubertal children","volume":"68","author":"Bravo","year":"2024","journal-title":"Arch Endocrinol Metab"},{"key":"ref66","doi-asserted-by":"publisher","first-page":"111389","DOI":"10.1016\/j.exger.2021.111389","article-title":"Comparative evaluation of inflammatory parameters and substitute insulin resistance indices in elderly women with and without type 2 diabetes mellitus","volume":"150","author":"Leite","year":"2021","journal-title":"Exp Gerontol"},{"key":"ref67","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1111\/jdi.14352","article-title":"Effect of adipose tissue deposition on insulin resistance in middle-aged and elderly women: Based on QCT and MRI mDIXON-Quant","volume":"16","author":"Liu","year":"2025","journal-title":"J Diabetes Investig"},{"key":"ref68","doi-asserted-by":"publisher","first-page":"7403796","DOI":"10.1155\/2019\/7403796","article-title":"Regulation of Inflammation in Autoimmune Disease","volume":"2019","author":"Duan","year":"2019","journal-title":"J Immunol Res"},{"key":"ref69","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1038\/nri.2016.49","article-title":"Neutrophil migration in infection and wound repair: going forward in reverse","volume":"16","author":"De Oliveira","year":"2016","journal-title":"Nat Rev Immunol"},{"key":"ref70","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s12199-018-0740-1","article-title":"Inflammation and cancer","volume":"23","author":"Murata","year":"2018","journal-title":"Environ Health Prev Med"},{"key":"ref71","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1111\/j.1440-1746.2005.04086.x","article-title":"Prevalence and risk factors of non-alcoholic fatty liver disease among Korean adults","volume":"21","author":"Park","year":"2006","journal-title":"J Gastroenterol Hepatol"},{"key":"ref72","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.1002\/hep.30626","article-title":"Sex Differences in Nonalcoholic Fatty Liver Disease: State of the Art and Identification of Research Gaps","volume":"70","author":"Lonardo","year":"2019","journal-title":"Hepatology"},{"key":"ref73","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1007\/s00125-019-05040-3","article-title":"Sex differences in metabolic regulation and diabetes susceptibility","volume":"63","author":"Tramunt","year":"2020","journal-title":"Diabetologia"},{"key":"ref74","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s12877-016-0202-9","article-title":"Gender differences in metabolic syndrome components among the Korean 66-year-old population with metabolic syndrome","volume":"16","author":"Lee","year":"2016","journal-title":"BMC Geriatr"},{"key":"ref75","doi-asserted-by":"publisher","first-page":"315","DOI":"10.3967\/bes2017.042","article-title":"Changes in Waist Circumference and Abdominal Obesity among Chinese Adults over a Ten-year Period","volume":"30","author":"Zhai","year":"2017","journal-title":"Biomed Environ Sci"},{"key":"ref76","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1007\/s00125-023-05891-x","article-title":"Sex differences in type 2 diabetes","volume":"66","author":"Kautzky-Willer","year":"2023","journal-title":"Diabetologia"},{"key":"ref77","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.mce.2014.11.029","article-title":"The sexual dimorphism of obesity","volume":"402","author":"Palmer","year":"2015","journal-title":"Mol Cell Endocrinol"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1569324\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T07:39:59Z","timestamp":1771918799000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1569324\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":77,"alternative-id":["10.3389\/fpubh.2025.1569324"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1569324","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]},"article-number":"1569324"}}