Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
Medicine (Baltimore). 2024 May 31;103(22):e38340. doi: 10.1097/MD.0000000000038340.
Nonalcoholic fatty liver disease (NAFLD) is a highly prevalent condition in the general population. Although recent studies have demonstrated a link between NAFLD and lipoprotein(a), a low-density lipoprotein-like particle synthesized in the liver, its precise physiological role and mechanism of action remain unclear. This study aimed to investigate the relationship between lipoprotein(a) levels and development of NAFLD and hepatic fibrosis in Korean adults. A total of 1501 subjects who underwent abdominal ultrasonography at least twice as part of a health checkup program were enrolled. Biochemical and ultrasonography results were analyzed longitudinally, and the degree of hepatic fibrosis was calculated in subjects with NAFLD using serum biomarkers, such as fibrosis-4 (FIB-4). During the 3.36-year follow-up period, 352 patients (23.5%) were diagnosed with NAFLD. The subjects were categorized into 4 groups based on their lipoprotein(a) levels. Remarkably, the incidence of NAFLD decreased as the lipoprotein(a) levels increased. Following logistic regression analysis and adjustment for various risk factors, the odds ratio for the development of NAFLD was 0.625 (95% CI 0.440-0.888; P = .032) when comparing the highest to the lowest tertile of lipoprotein(a). However, no significant association was observed between the occurrence of hepatic fibrosis and lipoprotein(a) levels in subjects with NAFLD. Lipoprotein(a) levels have been identified as a significant predictor of NAFLD development. Additional large-scale studies with extended follow-up periods are required to better understand the effect of lipoprotein(a) on NAFLD and hepatic fibrosis.
非酒精性脂肪性肝病（NAFLD）是一种在普通人群中高度普遍的疾病。尽管最近的研究表明 NAFLD 与脂蛋白（a）之间存在关联，脂蛋白（a）是一种在肝脏中合成的低密度脂蛋白样颗粒，但它的确切生理作用和作用机制仍不清楚。本研究旨在探讨韩国成年人脂蛋白（a）水平与 NAFLD 和肝纤维化发展之间的关系。共纳入了 1501 名至少两次接受腹部超声检查作为健康体检计划一部分的受试者。对生化和超声结果进行了纵向分析，并使用纤维化-4（FIB-4）等血清生物标志物计算了 NAFLD 患者的肝纤维化程度。在 3.36 年的随访期间，352 名患者（23.5%）被诊断为 NAFLD。根据脂蛋白（a）水平将受试者分为 4 组。值得注意的是，随着脂蛋白（a）水平的升高，NAFLD 的发病率降低。在进行逻辑回归分析并调整各种危险因素后，与最低三分位组相比，脂蛋白（a）水平最高的三分位组发生 NAFLD 的比值比为 0.625（95%CI 0.440-0.888；P=0.032）。然而，在 NAFLD 患者中，脂蛋白（a）水平与肝纤维化的发生之间没有显著关联。脂蛋白（a）水平被确定为 NAFLD 发展的重要预测指标。需要进行更多具有延长随访时间的大规模研究，以更好地了解脂蛋白（a）对 NAFLD 和肝纤维化的影响。
