Department of Cardiology, Jiangxi Provincial People's Hospital, Aiguo 152 Rd, Nanchang, 330006, China.
Department of Pediatrics, Lishui People's Hospital, No. 15 Dazhong St, Lishui, 323000, China.
Lipids Health Dis. 2021 Mar 25;20(1):28. doi: 10.1186/s12944-021-01457-1.
Low-density lipoprotein to high density lipoprotein (LDL/HDL) cholesterol ratio has been reported to predict the risk of many metabolic diseases. However, the association between the LDL/HDL cholesterol ratio and nonalcoholic fatty liver disease (NAFLD) has not been established.
A longitudinal cohort design was adopted in this study; 9767 non-obese subjects without NAFLD were included and analyzed. The subjects were grouped according to the quintile of LDL/HDL cholesterol ratio. The cumulative incidence of NAFLD and the independent effect of the LDL/HDL cholesterol ratio on NAFLD during 5 years of follow-up were calculated using the Kaplan-Meier method and Cox proportional-hazards regression model.
During the 5-year follow-up period, 841 subjects were diagnosed with new-onset NAFLD, and the 1-, 2-, 3-, 4-, and 5-year cumulative incidence rates of NAFLD were 1.16, 4.65, 8.33, 12.43, and 25.14%, respectively. In the multivariable-adjusted Cox proportional-hazards regression model, the LDL/HDL cholesterol ratio was significantly associated with the risk for NAFLD (HR: 1.66, 95% CI: 1.38-1.99, P trend< 0.001), especially among young people (HR: 3.96, 95% CI: 1.50-10.46, P interaction< 0.05). Additionally, receiver operating characteristic curve analysis showed that the LDL/HDL cholesterol ratio was better than HDL cholesterol and LDL cholesterol in predicting new-onset NAFLD.
LDL/HDL cholesterol ratio is an independent predictor of NAFLD in Chinese non-obese people with normal lipids, and its predictive value is higher than that of other lipoproteins. In clinical practice, the LDL/HDL cholesterol ratio can be used to identify people at high risk of NAFLD.
低密度脂蛋白与高密度脂蛋白（LDL/HDL）胆固醇比值已被报道可预测多种代谢性疾病的风险。然而，LDL/HDL 胆固醇比值与非酒精性脂肪性肝病（NAFLD）之间的关系尚未确定。
本研究采用纵向队列设计，纳入并分析了 9767 例无 NAFLD 的非肥胖受试者。根据 LDL/HDL 胆固醇比值的五分位数将受试者进行分组。采用 Kaplan-Meier 法和 Cox 比例风险回归模型计算 5 年随访期间 NAFLD 的累积发生率和 LDL/HDL 胆固醇比值对 NAFLD 的独立影响。
在 5 年随访期间，841 例受试者被诊断为新发 NAFLD，NAFLD 的 1、2、3、4 和 5 年累积发生率分别为 1.16%、4.65%、8.33%、12.43%和 25.14%。在多变量调整的 Cox 比例风险回归模型中，LDL/HDL 胆固醇比值与 NAFLD 风险显著相关（HR：1.66，95%CI：1.38-1.99，P 趋势<0.001），尤其是在年轻人中（HR：3.96，95%CI：1.50-10.46，P 交互<0.05）。此外，受试者工作特征曲线分析显示，LDL/HDL 胆固醇比值在预测新发 NAFLD 方面优于 HDL 胆固醇和 LDL 胆固醇。
LDL/HDL 胆固醇比值是中国非肥胖血脂正常人群中 NAFLD 的独立预测因子，其预测价值高于其他脂蛋白。在临床实践中，LDL/HDL 胆固醇比值可用于识别 NAFLD 高危人群。
