Recent data have suggested that nonalcoholic fatty liver disease (NAFLD) can occur in normal-weight subjects. This study examined the association of body fat percentage (BF%) with NAFLD and its risk factors in normal-weight individuals. Objectives: The present study aimed to explain the influence of body fat on the risk of NAFLD. Methods: A total of 59 subjects with body mass index (BMI) within the range of 18.5 - 24.9 kg/m2 were selected from referrals to two major university polyclinics in

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... raz, Iran, from April to June 2019. Fatty liver grade, anthropometric characteristics, body composition, and cardiometabolic risk factors were measured in this study. Results: Waist circumference (P = 0.012), fat mass (P < 0.001), triglycerides (TG) (P = 0.027), very-low-density lipoprotein (VLDL) (P = 0.007), and TG/high-density lipoprotein cholesterol (HDL-C) ratio (P = 0.003) increased; however, skeletal muscle mass decreased (P < 0.001) across the tertiles of BF%. The average of fatty liver grade was similar in the first and second tertiles; nevertheless, the fatty liver grade of participants in the third tertile was significantly higher (1.3 ± 0.9 vs. 0.4 ± 0.7; P = 0.005). In ordinal regression analysis, BF% (1.13; 95% CI: 1.04 - 1.22; P = 0.003), BMI (1.95; 95% CI: 1.02 - 3.74; P = 0.045), VLDL (1.77; 95% CI: 1.00 - 3.12; P = 0.049), and TG/HDL-C ratio (2.21; 95% CI: 1.26 - 3.86; P = 0.006) had positive associations with NAFLD; nonetheless, HDL-C (0.33; 95% CI: 0.16 - 0.67; P = 0.002) and dietary cholesterol (0.97; 95% CI: 0.95 - 0.997; P = 0.028) had inverse associations with NAFLD after the adjustments for age, gender, BMI, and physical activity. Conclusions: The results of this study suggested that within normal weight ranges, NAFLD occurs more frequently in individuals with higher BF%. In addition, BF% can be used as an important marker in NAFLD screening.