Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 55 2 2026 10 04 38737 38737 Hamid Adeli Fard Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Maryam Khosravi Shahid Dr. Beheshti hospital laboratory department, Sabzevar University of Medical Sciences: Sabzevar,Iran Ali Bahari Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mahboobeh Ghasemzadeh Rahbardar Clinical Research Development Unit, Shahid Hasheminejad Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Habibollah Esmaily Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Reza Rezvani Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Farahnaz Akrami Moghadam Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Mahsa Amarlou Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran Gordon Ferns Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex BN1 9PH, UK Maryam Saberi Karimian Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Majid Ghayour-Mobarhan Metabolic Syndrome research center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran 2025 04 05 2026 02 01 Background: The phase angle (PA) serves as an important indicator of cell membrane health and integrity, with higher values reflecting enhanced cell function. While malnutrition and the prognosis of chronic diseases have been extensively assessed, exploring the relationship between PA and Non-Alcoholic Fatty Liver Disease (NAFLD) has the potential to influence future disease management approaches. Aims: This study aimed to compare PA values across different NAFLD grades and investigate the correlation between anthropometric indices and phase angle measurements. Methods: A cross-sectional investigation was carried out on 191 people with NAFLD and 180 healthy controls. Anthropometric measurements were taken in the baseline using the Bio-Impedance Analyzer (In Body 770, In Body, South Korea), and hepatic steatosis was examined using FibroScan and ultrasound. The data was analyzed using SPSS version 16. Results: There was a significant unadjusted difference in trunk PA and whole-body PA between case and control groups (p< 0.001 and p< 0.05, respectively). After adjustment for confounders, the difference between different grades of fatty liver determined by ultrasound showed a significant difference (p< 0.001). Arm circumference emerged as the most positively correlated index influencing PA in both groups (p< 0.001), while the ratio of extracellular water to total body water exhibited the most negative correlation with PA (p< 0.001). Conclusions: The study found a substantial difference in PA levels between NAFLD patients and healthy individuals. Further research is needed to determine the potential of PA as a sensitive and specific predictor of NAFLD. https://ijph.tums.ac.ir/index.php/ijph/article/view/38737