Department of Endocrinology and Nutrition, Virgen de la Victoria University Hospital, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Faculty of Medicine, University of Malaga, 29010 Malaga, Spain.
Obesity, Diabetes and Metabolism Laboratory, Biomedical Research Institute of Murcia (IMIB), 30120 Murcia, Spain.
Nutrients. 2024 Apr 27;16(9):1310. doi: 10.3390/nu16091310.
Associations between dyslipidemia and metabolic dysfunction-associated steatotic liver disease (MASLD) have been reported. Previous studies have shown that the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio may be a surrogate marker of MASLD, assessed by liver ultrasound. However, no studies have evaluated the utility of this ratio according to biopsy-proven MASLD and its stages. Therefore, our aim was to evaluate if the TG/HDL-C ratio allows for the identification of biopsy-proven MASLD in patients with obesity. We conducted a case-control study in 153 patients with obesity who underwent metabolic surgery and had a concomitant liver biopsy. Fifty-three patients were classified as no MASLD, 45 patients as metabolic dysfunction-associated steatotic liver-MASL, and 55 patients as metabolic dysfunction-associated steatohepatitis-MASH. A receiver operating characteristic (ROC) analysis was performed to assess the accuracy of the TG/HDL-C ratio to detect MASLD. We also compared the area under the curve (AUC) of the TG/HDL-C ratio, serum TG, and HDL-C. A higher TG/HDL-C ratio was observed among patients with MASLD, compared with patients without MASLD. No differences in the TG/HDL-C ratio were found between participants with MASL and MASH. The greatest AUC was observed for the TG/HDL-C ratio (AUC 0.747, < 0.001) with a cut-off point of 3.7 for detecting MASLD (sensitivity = 70%; specificity = 74.5%). However, no statistically significant differences between the AUC of the TG/HDL-C ratio and TG or HDL-C were observed to detect MASLD. In conclusion, although an elevated TG/HDL-C ratio can be found in patients with MASLD, this marker did not improve the detection of MASLD in our study population, compared with either serum TG or HDL-C.
已有研究报道血脂异常与代谢相关脂肪性肝病（MASLD）之间存在关联。既往研究表明，肝超声评估的甘油三酯/高密度脂蛋白胆固醇（TG/HDL-C）比值可能是 MASLD 的替代标志物。然而，尚无研究根据肝活检证实的 MASLD 及其分期评估该比值的效用。因此，我们旨在评估 TG/HDL-C 比值是否可用于诊断肥胖患者的肝活检证实的 MASLD。我们对 153 例行代谢手术且同时进行肝活检的肥胖患者进行了病例对照研究。53 例患者无 MASLD，45 例患者为代谢相关脂肪性肝病-MASL，55 例患者为代谢相关脂肪性肝炎-MASH。进行了受试者工作特征（ROC）分析，以评估 TG/HDL-C 比值检测 MASLD 的准确性。我们还比较了 TG/HDL-C 比值、血清 TG 和 HDL-C 的曲线下面积（AUC）。与无 MASLD 的患者相比，有 MASLD 的患者的 TG/HDL-C 比值更高。在 MASL 和 MASH 患者之间，TG/HDL-C 比值无差异。TG/HDL-C 比值的 AUC 最大（AUC 0.747，<0.001），检测 MASLD 的切点为 3.7（敏感性=70%；特异性=74.5%）。然而，检测 MASLD 时，TG/HDL-C 比值的 AUC 与 TG 或 HDL-C 之间无统计学差异。总之，尽管 MASLD 患者中可发现 TG/HDL-C 比值升高，但与血清 TG 或 HDL-C 相比，该标志物并未提高本研究人群中 MASLD 的检出率。
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