Department of Hospital Infection, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
Department of Hepatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China.
Front Endocrinol (Lausanne). 2024 Oct 15;15:1457589. doi: 10.3389/fendo.2024.1457589. eCollection 2024.
Dyslipidemia is a known independent risk factor for Nonalcoholic fatty liver disease (NAFLD). However, the relationship between NAFLD and the serum non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio remains unclear. This study examined the association between the non-HDL-C to HDL-C ratio and NAFLD prevalence, including liver steatosis and fibrosis levels in the population.
We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018, including 4798 participants. Liver ultrasound and Transient Elastography (TE) were used to assess fibrosis and steatosis. Adjusted multivariable regression analyses, subgroup analyses based on BMI and sex, and a generalized additive model were employed to investigate the relationship between the non-HDL-C/HDL-C ratio and NAFLD.
Among the 4798 participants, 39.27% (n = 1,884) had NAFLD. Significant positive correlations between non-HDL-C/HDL-C and NAFLD risk were found across all models, with sex-stratified analyses indicating higher risk in men. Liver fibrosis was also associated with non-HDL-C/HDL-C ratios. The Receiver operating characteristic (ROC) analysis shows non-HDL-C/HDL-C as a better predictor for NAFLD than non-HDL-C or HDL-C alone.
Elevated non-HDL-C/HDL-C levels are independently associated with increased NAFLD and liver fibrosis risk in the American population, suggesting its utility in predicting NAFLD and related liver fibrosis.
血脂异常是非酒精性脂肪性肝病（NAFLD）的已知独立危险因素。然而，NAFLD 与血清非高密度脂蛋白胆固醇（non-HDL-C）与高密度脂蛋白胆固醇（HDL-C）比值之间的关系尚不清楚。本研究旨在探讨非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值与 NAFLD 患病率之间的关系，包括人群中的肝脂肪变性和纤维化程度。
我们使用 2017-2018 年全国健康和营养调查（NHANES）的数据进行了一项横断面研究，共纳入 4798 名参与者。使用肝脏超声和瞬时弹性成像（TE）评估纤维化和脂肪变性。采用调整后的多变量回归分析、基于 BMI 和性别进行的亚组分析以及广义加性模型来探讨非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值与 NAFLD 之间的关系。
在 4798 名参与者中，39.27%（n=1884）患有 NAFLD。所有模型均显示非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇与 NAFLD 风险之间存在显著的正相关，性别分层分析表明男性风险更高。肝纤维化也与非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值相关。受试者工作特征（ROC）分析表明，非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值比非高密度脂蛋白胆固醇或高密度脂蛋白胆固醇单独预测 NAFLD 的效果更好。
在美国人群中，升高的非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇水平与 NAFLD 和肝纤维化风险增加独立相关，提示其在预测 NAFLD 及相关肝纤维化方面具有一定的应用价值。
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