Zhou Yu-Ge, Tian Ning, Xie Wei-Ning
Affiliated Guangdong Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou University of Chinese Medicine, Foshan 528200, Guangdong Province, China.
Preventive Healthcare Center, Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Foshan 528200, Guangdong Province, China.
World J Hepatol. 2022 Apr 27;14(4):791-801. doi: 10.4254/wjh.v14.i4.791.
Nonalcoholic fatty liver disease (NAFLD) is characterized by hypertriglyceridemia, increased low-density lipoprotein cholesterol levels, and reduced high-density lipoprotein cholesterol (HDL-C) particles. Previous studies have shown that the total cholesterol to high-density lipoprotein cholesterol ratio (TC/HDL-C) was superior to other lipid metabolism biomarkers for predicting NAFLD risk and could be a new indicator of NAFLD. However, the association between TC/HDL-C and NAFLD in patients with hepatitis B virus (HBV) has not yet been determined.
To investigate the association between TC/HDL-C and NAFLD in a population with chronic hepatitis B (CHB).
In this study, 183 HBV-infected patients were enrolled. All participants underwent blood chemistry examinations and abdominal ultrasound. Univariate and multivariate logistic regression models, curve fitting analysis, and threshold calculation were used to assess the relationship between TC/HDL-C and NAFLD.
The overall prevalence of NAFLD was 17.49% ( = 32) in the 183 CHB participants. The TC/HDL-C of non-NAFLD and NAFLD patients were 3.83 ± 0.75 and 4.44 ± 0.77, respectively ( < 0.01). Logistic regression analysis showed that TC/HDL-C was not associated with NAFLD after adjusting for other pertinent clinical variables. However, at an optimal cutoff point of 4.9, a non-linear correlation between TC/HDL-C and NAFLD was detected. The effect size of the left and right sides of the inflection point were 5.4 (95% confidence interval: 2.3-12.6, < 0.01) and 0.5 (95% confidence interval: 0.1-2.2, = 0.39), respectively. On the left side of the inflection point, TC/HDL-C was positively associated with NAFLD. However, no significant association was observed on the right side of the inflection point.
This study demonstrated a non-linear correlation between TC/HDL-C and NAFLD in a population with CHB. TC/HDL-C was positively associated with NAFLD when TC/HDL-C was less than 4.9 but not when TC/HDL-C was more than 4.9.
非酒精性脂肪性肝病（NAFLD）的特征为高甘油三酯血症、低密度脂蛋白胆固醇水平升高以及高密度脂蛋白胆固醇（HDL-C）颗粒减少。既往研究表明，总胆固醇与高密度脂蛋白胆固醇比值（TC/HDL-C）在预测NAFLD风险方面优于其他脂质代谢生物标志物，可能是NAFLD的一项新指标。然而，TC/HDL-C与乙型肝炎病毒（HBV）感染患者的NAFLD之间的关联尚未确定。
探讨慢性乙型肝炎（CHB）人群中TC/HDL-C与NAFLD之间的关联。
本研究纳入了183例HBV感染患者。所有参与者均接受了血液生化检查和腹部超声检查。采用单因素和多因素逻辑回归模型、曲线拟合分析及阈值计算来评估TC/HDL-C与NAFLD之间的关系。
183例CHB参与者中NAFLD的总体患病率为17.49%（n = 32）。非NAFLD和NAFLD患者的TC/HDL-C分别为3.83±0.75和4.44±0.77（P < 0.01）。逻辑回归分析显示，在调整其他相关临床变量后，TC/HDL-C与NAFLD无关。然而，在最佳截断点为4.9时，检测到TC/HDL-C与NAFLD之间存在非线性相关性。拐点左侧和右侧的效应大小分别为5.4（95%置信区间：2.3 - 12.6，P < 0.01）和0.5（95%置信区间：0.1 - 2.2，P = 0.39）。在拐点左侧，TC/HDL-C与NAFLD呈正相关。然而，在拐点右侧未观察到显著关联。
本研究证明CHB人群中TC/HDL-C与NAFLD之间存在非线性相关性。当TC/HDL-C小于4.9时，TC/HDL-C与NAFLD呈正相关，而当TC/HDL-C大于4.9时则无此关联。
