Abstract
BackgroundAlthough nonalcoholic fatty liver disease (NAFLD) is commonly seen in metabolic abnormalities patients, NAFLD is also occurred in the non-obese individuals. The ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) is considered as a predictive factor of NAFLD. However, it is still difficult to confirm the correlation of TG/HDL-C ratio with NAFLD among non-obese Chinese people with normal blood lipid levels. In our study, it is aimed to analyze the correlation of TG/HDL-C ratio with NAFLD among non-obese Chinese population without dyslipidemia.MethodsIn the retrospective cohort study, 9838 non-obese subjects who were free of NAFLD were enrolled. NAFLD was diagnosed by ultrasonography.ResultsDuring the median follow-up period of 2.9 years, cumulative incidence of NAFLD in non-obesity individuals was 8.69% among the overall population; meanwhile, its incidence was gradually enhanced across the quartiles of TG/HDL-C ratio (0.61, 1.28, 2.55 and 4.25% respectively). Then the multivariate factors were adjusted. The multivariate cox regression analysis results showed that the hazard ratio of NAFLD in higher quartiles (Q2-Q4) was 2.10 (1.33–3.32), 3.11 (2.03–4.75) and 3.40 (2.24–5.17), respectively. Besides, the area under receiver operator characteristic curve (AUC) of TG/HDL-C ratio in the male was 0.70 (0.68–0.72) and 0.72 (0.70–0.75) in the female. The final values were dramatically larger than the other lipid index.ConclusionThere is an independent relationship between TG/HDL-C and NAFLD among non-obese Chinese population without dyslipidemia, and TG/HDL-C may be used as a better predictor for NAFLD.
Highlights
In clinical practice, nonalcoholic fatty liver disease (NAFLD) is a pathological syndrome that is reflected by excessive fatty deposition of hepatocyte without alcohol use and other causes of liver diseases [1]
Dyslipidemia is a well-documented influence factor of NAFLD, which can be reflected by the increased total cholesterol (TC) and triglyceride (TG) or declined HDLC levels and predominance of small dense low-density lipoprotein particles [8, 9]
While adjusting BMI, fasting plasma glucose (FPG), albumin, systolic blood pressure (SBP), diastolic blood pressure (DBP), ALT, aspartate transaminase (AST), BUN, Cr, uric acid and direct bilirubin, the hazard ratio (HR) for non-obese NAFLD patients was gradually enhanced across the quartiles of TG/HDL-C ratio
Summary
Demographic and clinical characteristic of the subjects at baseline In this study, 9838 subjects without NAFLD at baseline were covered. Compared with subjects of higher TG/HDL-C ratio, the subjects of lower TG/HDL-C ratio had higher clinical indexes like BMI, age, DBP, SBP, fasting plasma glucose (FPG), albumin, alanine aminotransferase (ALT), alkaline phosphatase (ALP), aspartate transaminase (AST), gamma glutamyl transpeptidase (GGT), creatinine, uric acid, TG, total cholesterol (TC) and LDL-C as well as the number of the males. Across the quartiles 1, 2, 3, and 4 of TG/HDL ratio, the cumulative incidence of NAFLD among non-obesity individuals was increased from (0.61(0.46–0.76), 1.28(1.06–1.50), 2.55(2.24–2.86) to 4.25(3.85–4.65) (Table 2). While adjusting BMI, FPG, albumin, SBP, DBP, ALT, AST, BUN, Cr, uric acid and direct bilirubin, the hazard ratio (HR) for non-obese NAFLD patients was gradually enhanced across the quartiles of TG/HDL-C ratio. The optimal cut-off point of TC/HDL-C ratio for non-obese NAFLD patients was 0.65 in the male and 0.69 in the female
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