Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong, China.
Department of Physical Examination, DongGuan Tungwah Hospital, Dongguan, China.
Sci Rep. 2024 Mar 13;14(1):6056. doi: 10.1038/s41598-024-56555-8.
There is limited research on the association between the alanine aminotransferase to high-density lipoprotein cholesterol ratio (ALT/HDL-C) ratio and nonalcoholic fatty liver disease (NAFLD). The purpose of the current research was to look into the connection between the ALT/HDL-C ratio and the risk of NAFLD in lean Chinese individuals. Between January 2010 and December 2014, 11,975 non-obese people participated in this prospective cohort research. The relationship between the ALT/HDL-C ratio and the risk of developing NAFLD was assessed using the Cox proportional-hazards regression model, Cox proportional hazards regression with cubic spline functions and smooth curve fitting, sensitivity analysis, and subgroup analyses. The ALT/HDL-C ratio's potential value as a NAFLD prognostic marker was to be evaluated using the receiver operating characteristic curve analysis. A total of 5419 (45.253%) women comprised the research's participant population, and the research participants' average age was 43.278 ± 14.941 years. The ALT/HDL-C ratio was 11.607 (7.973-17.422) at the median (interquartile ranges). 2087 (17.428%) patients had NAFLD diagnoses throughout a median follow-up of 24.967 months. The study's findings demonstrated a positive connection between the ALT/AHDL-C ratio and the incident NAFLD (HR = 1.037, 95% CI: 1.031-1.042) when adjusting for relevant factors. The ALT/HDL-C ratio and NAFLD risk had a nonlinear connection, with 12.963 as the ratio's inflection point. Effect sizes (HR) were 1.023 (95% CI: 1.017-1.029) and 1.204 (95% CI: 1.171-1.237), respectively, on the right and left sides of the inflection point. The sensitivity analysis also showed how reliable our findings were. According to subgroup analysis, those with BMI < 24 kg/m and DBP < 90 mmHg had a stronger correlation between the ALT/HDL-C ratio and NAFLD risk. The current study shows a positive and non-linear connection between the ALT/HDL-C ratio and NAFLD risk in lean Chinese individuals. When the ALT/HDL-C ratio is less than 12.963, it is significantly linked to NAFLD. Therefore, from a therapy standpoint, it is advised to keep the ALT/HDL-C ratio less than the inflection point.
目前关于丙氨酸氨基转移酶与高密度脂蛋白胆固醇比值（ALT/HDL-C）与非酒精性脂肪性肝病（NAFLD）之间的关联的研究有限。本研究的目的是探讨瘦型中国人 ALT/HDL-C 比值与 NAFLD 风险之间的关系。2010 年 1 月至 2014 年 12 月，11975 名非肥胖者参与了这项前瞻性队列研究。采用 Cox 比例风险回归模型、Cox 比例风险三次样条函数和光滑曲线拟合、敏感性分析和亚组分析来评估 ALT/HDL-C 比值与 NAFLD 发病风险之间的关系。通过接受者操作特征曲线分析来评估 ALT/HDL-C 比值作为 NAFLD 预后标志物的潜在价值。研究参与者的平均年龄为 43.278±14.941 岁，研究人群中共有 5419 名（45.253%）女性。中位数（四分位距）ALT/HDL-C 比值为 11.607（7.973-17.422）。在中位随访 24.967 个月期间，共有 2087 名（17.428%）患者被诊断为 NAFLD。研究结果表明，在调整相关因素后，ALT/AHDL-C 比值与新发 NAFLD 之间呈正相关（HR=1.037，95%CI：1.031-1.042）。ALT/HDL-C 比值与 NAFLD 风险之间存在非线性关系，12.963 为比值的拐点。拐点右侧和左侧的效应大小（HR）分别为 1.023（95%CI：1.017-1.029）和 1.204（95%CI：1.171-1.237）。敏感性分析也表明了我们的研究结果是可靠的。根据亚组分析，BMI<24kg/m2 和 DBP<90mmHg 的人群中，ALT/HDL-C 比值与 NAFLD 风险之间的相关性更强。本研究表明，瘦型中国人的 ALT/HDL-C 比值与 NAFLD 风险之间存在正相关和非线性关系。当 ALT/HDL-C 比值低于 12.963 时，与 NAFLD 显著相关。因此，从治疗的角度来看，建议将 ALT/HDL-C 比值保持在拐点以下。
