Higher non-HDL-cholesterol to HDL-cholesterol ratio linked with increased nonalcoholic steatohepatitis

Dianhui Wang,Zhanqing Wang,Ling Wang,Yihong Ni,Dongqing Jiang,Shihong Chen

doi:10.1186/s12944-018-0720-x

Abstract

BackgroundNon-HDL-cholesterol to HDL-cholesterol (non-HDL-c/HDL-c) ratio is a feasible predictor for coronary heart disease, metabolic syndrome, and insulin resistance. Patients with nonalcoholic steatohepatitis (NASH) have an increased risk of developing cardiovascular problems and type 2 diabetes. However, the predictive role of non-HDL-c/HDL-c ratio in NASH hasn’t been investigated yet.MethodsWe conducted a retrospective cohort study. A total of 3489 eligible subjects were selected in the present study. Prevalence and characteristics of NASH were demonstrated. Conditional logistic regression was used to analyze the association between non-HDL-c/HDL-c ratio and risks of NASH. Associations between non-HDL-c/HDL-c ratio and serum aminotransferase levels were also investigated.ResultsThe overall prevalence of NASH was 6.13%, higher in male (6.89%) than that in female (5.04%). Interestingly, the prevalence of NASH showed a positive correlation with the elevation of non-HDL-c/HDL-c ratio (Pearson’s Chi-squared test, linear trend 0.010, p < 0.05). The risk of NASH increased approximately 1.8-fold among subjects with higher non-HDL-c/HDL-c ratio. After adjustment for confounding factors, higher non-HDL-c/HDL-c ratio was still associated with a 54.4% increased risk of NASH. Male had higher risk of NASH than female when their non-HDL-c/HDL-c ratio increased. The risk of NASH in subjects with BMI more than 24 was 3 times higher than that in subjects with BMI less than 24. Every one unit increase in Non-HDL-c/HDL-c ratio was associated with 64.5% increase in ALT/AST level (p < 0.05) after adjustment for confounding factors.ConclusionsOur study provided strong evidence that subjects with higher non-HDL-c/HDL-c ratio had a higher risk of NASH, which suggested that non-HDL-c/HDL-c ratio might be a feasible predictor for NASH.

Highlights

Non-HDL-cholesterol to HDL-cholesterol ratio is a feasible predictor for coronary heart disease, metabolic syndrome, and insulin resistance
Significant differences were detected among the 3 groups with respect to BMI, diastolic blood pressure (DBP), total cholesterol (TC), TG, LDLc, fasting plasma glucose (FPG), Cr, Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), hypertension, and DM
After adjustment for confounding factors, the associations were even more significant (Table 4). By considering it as a continuous variable, we revealed that every one unit increase in Non-high-density lipoprotein cholesterol (HDL-c)/ HDL-c ratio was associated with 64.5% increase in ALT and AST levels (p < 0.001) after adjustment for confounding factors

Summary

Introduction

Non-HDL-cholesterol to HDL-cholesterol (non-HDL-c/HDL-c) ratio is a feasible predictor for coronary heart disease, metabolic syndrome, and insulin resistance. Non-alcoholic fatty liver disease (NAFLD) has emerged as the most common chronic liver disease worldwide in recent years, which was fueled by the increase in obesity and metabolic syndrome (MS) [1]. It ranges from fatty liver or hepatic steatosis to steatohepatitis with hepatic inflammation. UK Prospective Diabetes Study found that non-HDL-c/HDL-c ratio, rather than non-HDL-C, was a useful predictor for coronary heart disease (CHD) in type 2 diabetes patients [6]. This ratio was certified to be an effective predictor for CHD incidence in chronic kidney disease (CKD) patients [7], and an optimal predictor for MS and insulin resistance [8]

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