High-Density Lipoprotein Cholesterol Negatively Associated with Nonalcoholic Fatty Liver Disease in Non-Diabetic and Normal Weight Adults

Abstract

Goals and Background: Although non-alcoholic fatty liver disease (NAFLD) is closely associated with obesity and diabetes mellitus, it is not rare in non-diabetic and normal weight subjects. Which factors are associated with the presence of NAFLD in this special population remains unclear. Materials and Methods: A total of 207 non-diabetic (fasting plasma glucose＜126 mg/dL and without previous diabetic history) and normal weight (body mass index＜24 kg/m^2) individuals attending a health examination center were enrolled since September 2005 to December 2006. All the subjects were negative for serum hepatitis B surface antigen and antibody against hepatitis C virus, and consumed alcohol less than 140 g/week. Insulin resistance index was determined using homeostasis model assessment (HOMA-IR). Results: 70 subjects (33.8%) were identified to have ultrasonographic NAFLD, and remaining 137 (66.2%) served as controls. There was no significant difference in age and gender distribution between two groups. In nondiabetic and normal weight individuals, patients of NAFLD had raised body mass index, HOMA-IR, triglyceride, total cholesterol and low-density lipoprotein cholesterol, but reduced high-density lipoprotein cholesterol (HDL-C) as compared to controls by univariate analyses. Multivariate logistic regression analyses showed a negative association between HDL-C and the presence of NAFLD (odds ratio, 0.93; 95% confidence interval, 0.89-0.98; P＜0.01). Conclusions: Serum HDL-C level has a negative association with NAFLD in non-diabetic and normal weight adults, independent of other metabolic factors or insulin resistance.