Association of remnant cholesterol with nonalcoholic fatty liver disease: a general population-based study

Zou, Yang; Lan, Jianyun; Zhong, Yanjia; Yang, Shuo; Zhang, Huimin; Xie, Guobo

doi:10.1186/s12944-021-01573-y

Cited by 38 publications

(26 citation statements)

References 52 publications

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“…NAFLD is characterized by steatosis of the liver, which promotes the occurrence and progression of NAFLD with the participation of inflammation, oxidative stress and IR [ 11 , 32 ]. In many previous observational studies, various lipid abnormalities have received widespread attention because of their significant increase in the risk of NAFLD [ 11 , 33 ], among which the disorder of lipoproteins rich in TG is considered to be a key factor in cardiovascular risk in patients with NAFLD [ 34 ]. In this context, various lipid parameters and lipid ratios have been widely explored and studied, among which TG/HDL-C ratio seems to be a better predictor of NAFLD [ 13 , 14 ], which may be related to IR.…”

Section: Discussionmentioning

confidence: 99%

Association between the cardiometabolic index and non-alcoholic fatty liver disease: insights from a general population

et al. 2022

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Background Emerging evidence suggests that cardiometabolic index (CMI) is closely related to diabetes, hypertension, stroke, cardiovascular disease, and kidney disease, which implies that CMI has the value as an indicator of metabolic diseases. However, data on the relationships between CMI and non-alcoholic fatty liver disease (NAFLD) risks have not been reported. This study is designed to examine the association between CMI and NAFLD in the general population. Methods The current study included 14,251 subjects whose CMI was the product of triglyceride/high-density lipoprotein cholesterol ratio and waist-to-height ratio. Linear regression was used to analyze the correlation between baseline information and CMI, logistic regression was used to study the relationship between CMI and NAFLD, and subgroup analysis was used to explore potential high-risk groups. Results After adjusted for potential confounding factors, higher CMI was independently associated with NAFLD, in which every additional standard deviation (SD) of CMI increased the risk of NAFLD by 28% (OR 1.28 per SD increase, 95% CI 1.19–1.37, P for trend < 0.0001). There were also significant differences in CMI-related NAFLD risk among different ages and genders, in which the CMI-related NAFLD risk in young people was significantly higher than that in other age groups (OR = 2.63 per SD increase for young people, OR = 1.38 per SD increase for young and middle-aged people, OR = 1.18 per SD increase for middle-aged and elderly people; OR = 1.14 per SD increase for elderly people, P for interaction = 0.0010), and the CMI-related NAFLD risk in women was significantly higher than that in men (OR = 1.58 per SD increase for women, OR = 1.26 per SD increase for men, P for interaction = 0.0045). Conclusions Current studies have found that after excluding potential confounding factors, higher CMI in the general population is independently associated with NAFLD risk.

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Section: Discussionmentioning

confidence: 99%

Association between the cardiometabolic index and non-alcoholic fatty liver disease: insights from a general population

et al. 2022

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“…Our results are consistent with Zhang et al [23] . In addition to sensitivity analysis, we also compared UHR with recently proposed indicators for predicting new-onset NAFLD among lean adults [24][25][26][27][28] . The results showed that UHR was excellent in predictive value and sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Serum Uric Acid to HDL-Cholesterol Ratio is Associated with New-Onset NAFLD in Lean Chinese People with Normal Blood Lipid Levels: a Longitudinal Cohort Study

Zhu

Shi

et al. 2021

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Background: Nonalcoholic fatty liver disease (NAFLD) is commonly occurred in the non-obese individuals. The serum uric acid (UA) to high-density lipoprotein cholesterol (HDL-c) ratio (UHR) is considered as a predictive factor of NAFLD. However, it is still difficult to confirm the correlation in lean Chinese people with normal blood lipid levels. It is aimed to analyze the correlation of UHR with NAFLD among lean Chinese population without dyslipidemia and compared UHR with other predictors in this study.Methods: 9838 lean people without NAFLD were included in a retrospective cohort study. NAFLD was diagnosed by liver ultrasound.Results: A total of 9,838 lean patients with normal blood lipid levels were included in the final study. During the five-year follow-up period, the overall prevalence of NAFLD was 8.7%. across the quintile 1, 2, 3, 4 and 5 of UHR, the prevalence of NAFLD among lean patients was increased from 2.4%, 5%, 7.9%, 10.3% to 17.8%. After adjustment for age, markers of liver and kidney function, gender and metabolic indicators, multivariate cox proportional hazard regression analysis demonstrated that the hazard ratio(HR) was 1.99(1.43-2.73) in highest UHR (quintile 5) compared with lowest UHR(quintile 1). The area under the curve(AUC) of UHR (0.690) was higher than in UA (0.666) and HDL-c (0.636), which showed that the predictive ability of the UHR to new-onset NAFLD was better than serum uric acid and HDL-c. Even within the normal range of UA and HDL-c levels, UHR was independently associated with NAFLD, and HR (95% confidence interva, 95%CI) for NAFLD in Quintile 5 of UHR was 6.74(4.32-10.53). Compared with other significant predictors, the AUC value of UHR(0.67) was similar to that of low-density lipoprotein cholesterol(LDL-c)/HDL-c ratio(0.68), non-high-density lipoprotein cholesterol (NHDL-c)/HDL-c ratio(0.68) and alanine aminotransferase (ALT)/ aspartate aminotransferase (AST) ratio(0.7), and superior to that of LDL-c (0.63), remnant cholesterol (RC,0.59), albumin(ALB)/alkaline phosphatase(ALP) ratio(0.61). The sensitivity of UHR (70.5%) was the highest among all indicators. In the subgroup of ALT, the AUC of UHR was 0.70, which was the highest among all predictors in subjects with ALT< 40. For subjects with elevated ALT levels (ALT > 40 U/L), there was no statistical significance among RC (P=0.441), ALB/ALP (P=0.419) and ALT/AST(P=0.159). In contrast, UHR's performance in predicting NAFLD was meaningful and reliable (AUC=0.61, p<0.001).Conclusions: UHR serve as an inexpensive and reliable predictor of NAFLD in lean Chinese people with normal blood lipid levels. It can be used to identify people at high risk of NAFLD.

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“…NAFLD is associated with abnormal lipid metabolism and altered glucose metabolism. Patients with NAFLD tend to have high triglyceride concentrations, high low-density lipoprotein concentrations, oxidated low-density lipoprotein and remnant cholesterol, and low high-density lipoprotein concentrations, which are established risk factors for ASCVD [ 6 , 16 , 17 , 18 ]. Dyslipidemia can become one of the causes of NAFLD and also be worsened by NAFLD.…”

Section: The Interlink Connections Of Ascvd and Nafldmentioning

confidence: 99%

Association between Cardiovascular Disease and Liver Disease, from a Clinically Pragmatic Perspective as a Cardiologist

et al. 2023

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Cardiovascular diseases and liver diseases are closely related. Non-alcoholic fatty liver disease has the same risk factors as those for atherosclerotic cardiovascular disease and may also be a risk factor for atherosclerotic cardiovascular disease on its own. Heart failure causes liver fibrosis, and liver fibrosis results in worsened cardiac preload and congestion. Although some previous reports regard the association between cardiovascular diseases and liver disease, the management strategy for liver disease in patients with cardiovascular diseases is not still established. This review summarized the association between cardiovascular diseases and liver disease. In patients with non-alcoholic fatty liver disease, the degree of liver fibrosis progresses with worsening cardiovascular prognosis. In patients with heart failure, liver fibrosis could be a prognostic marker. Liver stiffness assessed with shear wave elastography, the fibrosis-4 index, and non-alcoholic fatty liver disease fibrosis score is associated with both liver fibrosis in patients with liver diseases and worse prognosis in patients with heart failure. With the current population ageing, the importance of management for cardiovascular diseases and liver disease has been increasing. However, whether management and interventions for liver disease improve the prognosis of cardiovascular diseases has not been fully understood. Future investigations are needed.

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Association of remnant cholesterol with nonalcoholic fatty liver disease: a general population-based study

Cited by 38 publications

References 52 publications

Association between the cardiometabolic index and non-alcoholic fatty liver disease: insights from a general population

Association between the cardiometabolic index and non-alcoholic fatty liver disease: insights from a general population

Serum Uric Acid to HDL-Cholesterol Ratio is Associated with New-Onset NAFLD in Lean Chinese People with Normal Blood Lipid Levels: a Longitudinal Cohort Study

Association between Cardiovascular Disease and Liver Disease, from a Clinically Pragmatic Perspective as a Cardiologist

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