Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Atherosclerosis. 2020 Sep;308:1-5. doi: 10.1016/j.atherosclerosis.2020.07.020. Epub 2020 Jul 30.
High lipoprotein(a) [Lp(a)] levels are associated with increased risk of cardiovascular disease. However, the association between Lp(a) and fatty liver disease (FLD) remains controversial. Therefore, we analyzed the relationship between FLD and serum Lp(a) levels in Korean adults.
A total of 22,534 participants who underwent a routine health screening program at Kangbuk Samsung Hospital in 2010 and 2014 were enrolled. Anthropometric and biochemical parameters, including Lp(a), were measured. The presence of FLD was assessed using abdominal ultrasonography. Odds ratios (ORs) for the presence of FLD were analyzed in quartile groups of serum Lp(a) levels using logistic regression. We divided the participants into four groups according to the median values of Lp(a) and homeostasis model assessment for insulin resistance (HOMA-IR).
Among the total study population, 3030 (13.4%) participants had fatty liver disease. The mean Lp(a) level was lower in subjects with FLD than in those without (70.0 vs 73.8 nmol/L, p < 0.001). The OR for FLD was the lowest in the fourth Lp(a) quartile group, using the first quartile group as the reference group after adjusting for confounding factors [0.815; 95% confidence interval (CI) 0.725-0.916]. When the OR for FLD was analyzed in four groups divided by the median values of Lp(a) and HOMA-IR, the low Lp(a)-high HOMA-IR group had the greatest OR for FLD, using the high Lp(a)-low HOMA-IR group as the reference (1.903; 95% CI 1.679-2.158).
Serum Lp(a) levels were inversely associated with the presence of FLD. Subjects with low Lp(a) and high insulin resistance (IR) showed higher risk of FLD than those with high Lp(a) and low IR, suggesting the opposite associations of Lp(a) and IR with FLD.
高脂蛋白(a) [Lp(a)]水平与心血管疾病风险增加相关。然而，Lp(a)与脂肪肝疾病 (FLD)之间的关系仍存在争议。因此，我们分析了韩国成年人中 FLD 与血清 Lp(a)水平之间的关系。
共纳入 2010 年和 2014 年在 Kangbuk Samsung 医院进行常规健康筛查的 22534 名参与者。测量了包括 Lp(a)在内的人体测量和生化参数。使用腹部超声评估 FLD 的存在。使用逻辑回归分析了按血清 Lp(a)水平四分位组划分的 FLD 存在的优势比 (OR)。我们根据 Lp(a)和胰岛素抵抗的稳态模型评估 (HOMA-IR) 的中位数将参与者分为四组。
在总研究人群中，3030 名（13.4%）参与者患有脂肪肝疾病。与无 FLD 者相比，FLD 患者的 Lp(a)平均水平较低（70.0 与 73.8 nmol/L，p < 0.001）。在调整混杂因素后，使用四分位组 1 作为参考组，第四 Lp(a)四分位组的 FLD 比值比最低[0.815；95%置信区间 (CI) 0.725-0.916]。当根据 Lp(a)和 HOMA-IR 的中位数将参与者分为四组进行分析时，使用高 Lp(a)-低 HOMA-IR 组作为参考，低 Lp(a)-高 HOMA-IR 组的 FLD 比值比最大（1.903；95%CI 1.679-2.158）。
血清 Lp(a)水平与 FLD 的存在呈负相关。Lp(a)水平低且胰岛素抵抗 (IR) 高的患者发生 FLD 的风险高于 Lp(a)水平高且 IR 低的患者，这表明 Lp(a)和 IR 与 FLD 的关联相反。
