Oxidized High-Density Lipoprotein Shows a Stepwise Increase as Fibrosis Progresses in Patients with Nonalcoholic Fatty Liver Disease.

Kouichi Miura,Naoshi Arai,Hironori Yamamoto,Kazuhiko Kotani,Norio Isoda,Rie Goka,Naoki Morimoto,Shunji Watanabe

doi:10.3390/antiox10020239

Abstract

Patients with nonalcoholic fatty liver disease (NAFLD) show dyslipidemia and a high risk for coronary heart disease (CHD). However, conventional atherosclerotic lipids are found at low levels in NAFLD patients with advanced fibrosis, in whom the risk for CHD is extremely high. The aim of the present study was to evaluate the levels of oxidized high-density lipoprotein (oxHDL), an emerging atherosclerotic biomarker, in patients with NAFLD. A total of 32 non-NAFLD subjects and 106 patients with NAFLD were enrolled. The fibrosis grades were stratified using non-invasive methods, including the Fibrosis-4 index and NAFLD fibrosis score. Total cholesterol and low-density lipoprotein (LDL)-cholesterol levels were significantly low in patients with advanced liver fibrosis. In contrast, oxHDL levels were high in NAFLD patients and showed a stepwise increase as fibrosis progressed. These oxHDL levels were independent of the HDL cholesterol levels, and statin use did not influence the oxHDL levels. Obese patients showed no increase in oxHDL levels, whereas patients with a low handgrip strength showed high oxHDL levels in NAFLD with advanced fibrosis. In conclusion, oxHDL is a potential biomarker for assessing the status of patients with NAFLD, including CHD and metabolic/nutritional disturbance, and particular cases with advanced liver fibrosis.

Highlights

Nonalcoholic fatty liver disease (NAFLD) is a hepatic feature of metabolic syndrome.Sedative lifestyles and high caloric diets, in combination with genetic background, contribute to the development of NAFLD [1]
We showed that the oxidized high-density lipoprotein (oxHDL) levels were higher in the NAFLD
OxHDL has the potential to assess the risk of coronary heart disease (CHD) when conventional atherosclerotic lipid levels are low in patients with advanced liver fibrosis

Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is a hepatic feature of metabolic syndrome.Sedative lifestyles and high caloric diets, in combination with genetic background, contribute to the development of NAFLD [1]. Nonalcoholic fatty liver disease (NAFLD) is a hepatic feature of metabolic syndrome. The number of patients with NAFLD is sharply increasing worldwide. NAFLD and nonalcoholic steatohepatitis (NASH) can progress to cirrhosis and liver cancer. The leading cause of death in patients with NAFLD is cardiovascular diseases (CVDs) [2]. We must pay close attention to CVDs as well as hepatic complications in patients with NAFLD. Patients with NAFLD are characterized by dyslipidemia, including hypercholesterolemia, hypertriglyceridemia, and low concentrations of high-density lipoprotein (HDL) cholesterol [3]. Cholesterol plays an important role in the development of NAFLD in experimental models [4] as well as clinical settings [5]. Cholesterol-lowering agents can decrease transaminases in patients with NAFLD [6]

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