Zhou C, Peng Y, Jiang W, et al. - In nonobese maintenance hemodialysis (MHD) patients, a high prevalence of metabolically unhealthy ones was evident. Performance of visceral adiposity index (VAI) and lipid accumulation product (LAP) was better than that of Chinese visceral adiposity index in differentiating metabolically unhealthy nonobese (MUNO) in MHD patients. Though a body shape index (ABSI) may be a weak predictor of MUNO, it is not superior to waist-to-hip ratio, waist circumference, and body mass index.

• In this multicenter cross-sectional study, 1302 nonobese adult MHD patients were included.

• Metabolically unhealthy status was present in 65.6% participants.

• Seven obesity indices were tested, and by receiver operator curve analysis, the highest diagnostic accuracy for MUNO phenotype was offered by the VAI (AUC 0.84 for women and 0.79 for men) followed by LAP (AUC 0.78 for women and 0.72 for men) while ABSI showed the lowest AUC value for detecting MUNO phenotype.