An international study led by Peking University reveals that a simple waist measurement can effectively identify children at risk of metabolic dysfunction-associated steatotic liver disease, offering a low-cost, practical screening method worldwide.
A simple waist measurement may help doctors spot children at risk of metabolic dysfunction-associated steatotic liver disease more reliably than expected, according to an international study led by researchers at Peking University.
The research suggests that the waist-to-height ratio, or WHtR, can serve as a practical first-line screening tool across children and adolescents from different ethnic and genetic backgrounds. The study found that a cutoff of 0.48 performed consistently well, while adding genetic risk scores offered little extra value for initial screening.
Metabolic dysfunction-associated steatotic liver disease, known as MASLD, is now regarded as the most common chronic liver condition in children and adolescents, reflecting the rise in childhood obesity. Because many affected young people are not identified early, clinicians and public health programmes have been looking for inexpensive ways to flag those who may need further testing. The researchers said their aim was to test whether a single measurement could work in settings where advanced laboratory tools or genetic testing are not readily available.
The team analysed data from Chinese schoolchildren and from the United States National Health and Nutrition Examination Survey to see how WHtR performed in different populations. According to the study published in the World Journal of Pediatrics, genetic differences at MASLD-related loci were generally modest, although they were somewhat greater among children of African ancestry and moderate among South Asian populations. Even so, the WHtR threshold remained largely stable. In the U.S. data, a ratio of 0.48 identified at-risk children effectively across most ethnic groups, with the exception of the “other Hispanic” category.
The findings also build on earlier work suggesting that WHtR-based screening can be cost-effective. Separate studies published in Healthcare found that two-stage WHtR screening strategies for paediatric MASLD in China were economically attractive at a range of willingness-to-pay levels, reinforcing the appeal of a simple tape-measure approach.
The broader implication is that WHtR could be useful well beyond specialist clinics. In higher-income countries, it may help refine which children need more detailed assessment. In lower- and middle-income settings, where genetic testing is often unavailable, it could offer schools, primary care clinicians and community health workers a low-cost way to identify children who should be followed up. The authors cautioned, however, that WHtR is a screening measure rather than a diagnosis, and any positive result still needs clinical confirmation.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
