Wu Weitao, Wu Donghai, Cao Changchun, Zhou Ronghua, Ding Shihua, Ying Ying, Sun Dayong, Hu Haofei
Department of Gastroenterology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.
Shenzhen University Health Science Center, Shenzhen, Guangdong, China.
Front Med (Lausanne). 2025 Aug 15;12:1618576. doi: 10.3389/fmed.2025.1618576. eCollection 2025.
Current evidence concerning the association between lipoprotein combine index (LCI) and Non-alcoholic fatty liver disease (NAFLD) in non-obese people remains limited. This 5-year longitudinal cohort study aimed to explore the connection between LCI and risk of NAFLD in non-obese Chinese individuals with normal lipids.
This retrospective cohort study from January 2010 to December 2014 consecutively and non-selectively collected 9,838 non-obese participants with normal lipid profiles in a Chinese hospital. Using the Cox proportional-hazards regression model, we explored the relationship between baseline LCI and NAFLD risk. We applied cubic spline functions and curve fitting to characterize the non-linear association between LCI and NAFLD. Simultaneously, we conducted sensitivity and subgroup analyses, and employed receiver operating characteristic (ROC) curve analysis to evaluate the predictive potential of LCI for NAFLD incidence.
The mean age of participants was 42.46 ± 14.70 years, with males comprising 51.40% of the cohort. During a median follow-up period of 33.10 months, 855 participants (8.89%) progressed NAFLD, with an incidence of 31.51 cases per 1,000 person-years. A significant non-linear relationship was identified between LCI and NAFLD risk with an inflection point at 5.514 mmol/L, where the HR was significantly stronger below this threshold (HR = 1.282, 95%CI: 1.162-1.415) compared to above it (HR = 1.063, 95%CI: 1.042-1.084). Subgroup analysis revealed the strongest associations in participants with body mass index (BMI) between 18.5 and 24 kg/m. LCI demonstrated superior predictive value for NAFLD compared to individual lipid parameters, with an area under the ROC curve of 0.717.
This study offers novel insights into the relationship between LCI and NAFLD risk in non-obese Chinese individuals with normal lipid levels. The non-linear association and the moderate discriminatory ability of LCI suggest its potential utility as a practical screening marker for population-level risk stratification and early preventive strategies in seemingly low-risk, normal-weight populations.
目前关于非肥胖人群中脂蛋白综合指数（LCI）与非酒精性脂肪性肝病（NAFLD）之间关联的证据仍然有限。这项为期5年的纵向队列研究旨在探讨LCI与血脂正常的非肥胖中国人群患NAFLD风险之间的联系。
这项回顾性队列研究于2010年1月至2014年12月在中国一家医院连续且非选择性地收集了9838名血脂正常的非肥胖参与者。使用Cox比例风险回归模型，我们探讨了基线LCI与NAFLD风险之间的关系。我们应用三次样条函数和曲线拟合来描述LCI与NAFLD之间的非线性关联。同时，我们进行了敏感性和亚组分析，并采用受试者工作特征（ROC）曲线分析来评估LCI对NAFLD发病率的预测潜力。
参与者的平均年龄为42.46±14.70岁，男性占队列的51.40%。在中位随访期33.10个月期间，855名参与者（8.89%）进展为NAFLD，发病率为每1000人年31.51例。LCI与NAFLD风险之间存在显著的非线性关系，拐点为5.514 mmol/L，低于该阈值时HR显著更强（HR = 1.282，95%CI：1.162 - 1.415），高于该阈值时（HR = 1.063，95%CI：1.042 - 1.084）。亚组分析显示，体重指数（BMI）在18.5至24 kg/m之间的参与者中关联最强。与个体血脂参数相比，LCI对NAFLD具有更好的预测价值，ROC曲线下面积为0.717。
本研究为血脂正常的非肥胖中国人群中LCI与NAFLD风险之间的关系提供了新的见解。LCI的非线性关联和中等区分能力表明其作为一种实用的筛查标志物，在看似低风险、正常体重人群的人群水平风险分层和早期预防策略中具有潜在效用。
