BMI-C as a predictor of advanced liver fibrosis: mediation by insulin and synergy at F3+ in two NHANES cohorts (2017–23)

Abstract Introduction: Liver fibrosis is the advanced stage of metabolic dysfunction-associated steatotic liver disease (MASLD), affecting about 10% of adults with steatosis. BMI, the main anthropometric tool, does not distinguish fat mass from lean mass and does not capture central fat distribution. BMI-C (Body Morphometric Index – Corrected) is a proprietary index that corrects the dimensional error of BMI, identifies 23.7% of normal-BMI individuals at metabolic risk, and correlates fibrosis with insulin.