Abstract
BackgroundLipid metabolism disorders play a critical role in the progression of non-alcoholic fatty liver disease (NAFLD). However, the number of studies on the relationships among blood lipid-related indexes and NAFLD is limited, and few studies have emphasized the comparison of blood lipid-related indexes in the same population to identify the optimal index for NAFLD screening. This study aimed to investigate the relationships among several blood lipid-related indexes and NAFLD, and to find the index with the best screening value for NAFLD.MethodsBased on a general health examination at community health service agencies in the Pearl River Delta region of China in 2015, 3239 women were recruited in this cross-sectional study. The relationships among blood lipid-related indexes and NAFLD were assessed separately by constructing multivariate logistic regression models. Receiver operating characteristic analysis was used to evaluate and compare the screening abilities of the indexes for NAFLD. All data analyses were conducted in SPSS and MedCalc software.ResultsWhether in the crude model or each model adjusted for possible confounding factors, the risk of NAFLD significantly rose with increasing cardiometabolic index (CMI), triglyceride glucose index (TyG), triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C) ratio (TG/HDL-C), total cholesterol (TC) to HDL-C ratio (TC/HDL-C) and low-density lipoprotein (LDL-C) to HDL-C ratio (LDL-C/HDL-C). Moreover, the area under the curve (AUC) of CMI was 0.744, which was better than that of TyG (0.725), TG/HDL-C (0.715), TC/HDL-C (0.650), and LDL-C/HDL-C (0.644) (P < 0.001). In addition, the optimal cut-off points were 0.62 for CMI, 8.55 for TyG, 1.15 for TG/HDL-C, 4.17 for TC/HDL-C, and 2.22 for LDL-C/HDL-C.ConclusionsCMI is easy to obtain, is a recommended index in the screening of NAFLD in women and may be useful for detecting populations that are at high risk of NAFLD.
Highlights
Lipid metabolism disorders play a critical role in the progression of non-alcoholic fatty liver disease (NAFLD)
Association between blood lipid‐related indexes and NAFLD Table 2 and Fig. 1 present the relationships between NAFLD and blood lipid-related indexes when they were analyzed as categorical variables and continuous variables, respectively
Based on z-score standardization, for each 1-unit increase in standard deviation (SD) for cardiometabolic index (CMI), triglyceride glucose index (TyG), TG/high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC)/ HDL-C or low-density lipoprotein cholesterol (LDL-C)/HDL-C, the risk of NAFLD increased by 31.0% (OR: 1.310, 95% Confidence interval (CI) 1.198–1.433), 71.6% (OR: 1.716, 95% CI 1.520–1.936), 27.7% (OR: 1.277, 95% CI 1.175–1.389), 26.7% (OR: 1.267, 95% CI 1.133–1.417), and 23.7% (OR: 1.237, 95% CI 1.110–1.378), respectively, in model III
Summary
Lipid metabolism disorders play a critical role in the progression of non-alcoholic fatty liver disease (NAFLD). NASH has the potential to progress to cirrhosis and hepatocellular carcinoma (HCC), leading to liver transplantation or death among some patients [6]. It has been reported that NAFLD-related HCC is the most rapidly growing cause of liver transplantation in the USA, and in 2014, the total estimated national hospitalization costs to patients with NAFLD reached $19.9 billion [7, 8]. Patients with NAFLD have a high prevalence of various comorbidities (e.g., metabolic syndrome [MS], cardiovascular disease and chronic kidney disease, et al.), which lead to increasing hospitalization charges and decreasing quality of life [5, 10,11,12]. More attention should be given to NAFLD based on the above characteristics
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