Li Juyi, Kou Chunjia, Chai Yuwei, Li Yuchen, Liu Xue, Zhang Li, Zhang Haiqing
Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China.
Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Jinan, Shandong, China.
Front Nutr. 2025 Feb 27;11:1508106. doi: 10.3389/fnut.2025.1508106. eCollection 2025.
The non-HDL-C to HDL-C ratio (NHHR) is a dependable lipid marker linked to atherosclerotic traits. This study examines the potential relationship between NHHR and both metabolic dysfunction-associated steatotic liver disease (MASLD) and advanced liver fibrosis.
This study investigated the relationship between NHHR levels and both MASLD and advanced liver fibrosis using data from the 2017-2020 National Health and Nutrition Examination Survey (NHANES) in the United States. First, we conducted a baseline characteristics analysis of the population based on NHHR quartiles. Second, we employed multivariable weighted linear regression models to examine the associations between NHHR and MASLD, as well as advanced liver fibrosis. Third, we utilized restricted cubic splines (RCS) to assess potential non-linear relationships. Fourth, we performed subgroup analyses. Finally, ROC curve analysis was conducted to evaluate the effectiveness of NHHR.
In the main analysis, this study included a total of 9,864 participants. Following multivariable logistic regression and comprehensive adjustments, elevated NHHR levels in the Q3 and Q4 groups were significantly linked to MASLD, with odds ratios of 1.59 (95% CI: 1.20-2.11) and 1.83 (95% CI: 1.40-2.39), respectively ( for trend < 0.0001). Elevated NHHR levels in the Q2 and Q3 groups remained significantly linked to a decreased risk of advanced liver fibrosis, with odds ratios of 0.61 (95% CI 0.40-0.94, = 0.03) and 0.64 (95% CI 0.47-0.89, = 0.01), respectively. RCS analysis revealed a U-shaped nonlinear association between NHHR and both MASLD ( = 0.000; for nonlinear = 0.029) and advanced liver fibrosis ( = 0.0001; for nonlinear = 0.000). In the subgroup analysis, we found that this relationship was significant only in certain subgroups. The ROC curve analysis revealed that NHHR exhibited the best predictive performance for diagnosing MASLD based on the fatty liver index (FLI). The optimal cutoff point for NHHR in predicting MASLD using FLI was determined to be 2.476, with sensitivity and specificity values of 0.589 and 0.698, respectively.
NHHR may serve as a predictive marker for MASLD and advanced liver fibrosis, highlighting its potential significance in risk assessment and prevention strategies.
非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值（NHHR）是一种与动脉粥样硬化特征相关的可靠血脂指标。本研究探讨了NHHR与代谢功能障碍相关脂肪性肝病（MASLD）及晚期肝纤维化之间的潜在关系。
本研究利用美国2017 - 2020年国家健康与营养检查调查（NHANES）的数据，研究NHHR水平与MASLD及晚期肝纤维化之间的关系。首先，我们根据NHHR四分位数对人群进行了基线特征分析。其次，我们采用多变量加权线性回归模型来研究NHHR与MASLD以及晚期肝纤维化之间的关联。第三，我们使用受限立方样条（RCS）来评估潜在的非线性关系。第四，我们进行了亚组分析。最后，进行ROC曲线分析以评估NHHR的有效性。
在主要分析中，本研究共纳入9864名参与者。经过多变量逻辑回归和全面调整后，Q3组和Q4组中升高的NHHR水平与MASLD显著相关，优势比分别为1.59（95%CI：1.20 - 2.11）和1.83（95%CI：1.40 - 2.39）（趋势P < 0.0001）。Q2组和Q3组中升高的NHHR水平与晚期肝纤维化风险降低仍显著相关，优势比分别为0.61（95%CI 0.40 - 0.94，P = 0.03）和0.64（95%CI 0.47 - 0.89，P = 0.01）。RCS分析显示NHHR与MASLD（P = 0.000；非线性P = 0.029）和晚期肝纤维化（P = 0.0001；非线性P = 0.000）之间均呈U型非线性关联。在亚组分析中，我们发现这种关系仅在某些亚组中显著。ROC曲线分析显示，基于脂肪肝指数（FLI），NHHR在诊断MASLD方面表现出最佳预测性能。使用FLI预测MASLD时，NHHR的最佳截断点确定为2.476，敏感性和特异性值分别为0.589和0.698。
NHHR可能作为MASLD和晚期肝纤维化的预测指标，突出了其在风险评估和预防策略中的潜在意义。
