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Table 4 Adjusted direct and indirect associations of FM/FFM with NAFLD by sex and obesity status

From: Fat mass to fat-free mass ratio and the risk of non-alcoholic fatty liver disease and fibrosis in non-obese and obese individuals

Potential mediators Non-obesity Obesity
Total effect Controlled direct effect Natural indirect effect Proportion mediated (%) Total effect Controlled direct effect Natural indirect effect Proportion
mediated (%)
Men
 HOMA-IR 1.58 (1.20–2.06) 1.41 (1.08–1.82) 1.13 (1.05–1.24) 30.8 1.36 (1.08–1.68) 1.31 (1.03–1.62) 1.04 (1.00–1.09) 14.5
 Fasting glucose 1.57 (1.21–2.03) 1.57 (1.21–2.02) 1.00 (0.99–1.02) 0.9 1.36 (1.09–1.72) 1.36 (1.09–1.73) 1.00 (0.98–1.02) − 1.0
 Total cholesterol 1.58 (1.25–1.96) 1.57 (1.23–1.94) 1.00 (0.96–1.05) 0.7 1.36 (1.09–1.69) 1.31 (1.04–1.63) 1.04 (1.00–1.09) 13.7
 Triglycerides 1.59 (1.24–2.11) 1.50 (1.18–1.96) 1.06 (1.01–1.15) 15.4 1.35 (1.07–1.7) 1.28 (1.01–1.63) 1.06 (1.01–1.13) 20.7
 HDL-C 1.60 (1.24–2.03) 1.48 (1.16–1.92) 1.08 (1.02–1.17) 19.2 1.36 (1.08–1.72) 1.36 (1.08–1.71) 1.00 (0.99–1.02) 1.2
 LDL-C 1.56 (1.23–1.98) 1.53 (1.20–1.93) 1.02 (0.97–1.08) 5.5 1.36 (1.08–1.76) 1.34 (1.06–1.74) 1.02 (0.99–1.05) 5.6
 SBP 1.59 (1.24–2.04) 1.53 (1.20–1.93) 1.04 (0.99–1.09) 9.5 1.36 (1.08–1.75) 1.34 (1.06–1.70) 1.02 (0.99–1.05) 6.0
 White blood cells 1.55 (1.17–1.98) 1.43 (1.09–1.79) 1.09 (1.02–1.16) 22.1 1.40 (1.12–1.77) 1.37 (1.08–1.74) 1.03 (0.99–1.09) 9.8
Women
 HOMA-IR 1.48 (1.23–1.79) 1.40 (1.17–1.70) 1.05 (1.02–1.09) 15.1 1.30 (1.11–1.52) 1.25 (1.06–1.45) 1.04 (1.01–1.08) 17.3
 Fasting glucose 1.45 (1.21–1.73) 1.46 (1.22–1.73) 1.00 (0.99–1.00) − 0.7 1.30 (1.11–1.54) 1.31 (1.12–1.57) 0.99 (0.97–1.00) − 4.1
 Total cholesterol 1.46 (1.21–1.78) 1.43 (1.20–1.73) 1.02 (1.00–1.05) 7.1 1.29 (1.10–1.51) 1.29 (1.10–1.50) 1.01 (1.00–1.02) 2.4
 Triglycerides 1.47 (1.23–1.77) 1.34 (1.12–1.63) 1.10 (1.06–1.14) 27.4 1.30 (1.11–1.53) 1.28 (1.09–1.49) 1.02 (0.99–1.05) 7.2
 HDL-C 1.49 (1.25–1.81) 1.41 (1.18–1.70) 1.06 (1.03–1.10) 16.9 1.31 (1.11–1.56) 1.29 (1.10–1.52) 1.02 (0.99–1.04) 6.3
 LDL-C 1.46 (1.23–1.77) 1.43 (1.20–1.74) 1.02 (0.99–1.05) 7.0 1.30 (1.12–1.52) 1.29 (1.11–1.51) 1.01 (1.00–1.02) 2.8
 SBP 1.46 (1.21–1.75) 1.46 (1.21–1.76) 1.00 (0.98–1.02) 0.9 1.30 (1.12–1.56) 1.29 (1.10–1.53) 1.01 (1.00–1.03) 4.8
 White blood cells 1.48 (1.23–1.80) 1.44 (1.20–1.75) 1.02 (1.00–1.05) 7.1 1.29 (1.09–1.51) 1.26 (1.07–1.47) 1.02 (1.00–1.05) 9.2
  1. Data are odds ratio (OR) and 95% confidence interval (CI)
  2. The covariates were age, current smoking, current drinking, active physical activity, and education level
  3. The mediating effects of each mediator were tested by applying the counterfactual mediation method. Controlled direct effect (CDE) represented the effect of exposure on the outcome via pathways that do not involve the mediator, natural indirect effects (NIE) represented the effect of exposure on the outcome operating through the mediators, and the total effect represented the sum of all ways of the effect of exposure on the outcome. The proportions of the association between the exposure and the outcome which is mediated by the mediators were calculated using the following formula: (CDE * (NIE − 1))/(CDE * NIE − 1)
  4. FM/FFM fat-to-fat free mass ratio, OR odds ratio, CI confidence interval, SD standard deviation, HOMA-IR homeostasis model assessment of insulin resistance, HDL-C high density lipoprotein cholesterol, LDL-C low density lipoprotein cholesterol, SBP systolic blood pressure