Remnant cholesterol/high-density lipoprotein cholesterol ratio is a new powerful tool for identifying non-alcoholic fatty liver disease

Zou, Yang; Hu, Chong; Kuang, Maobin; Chai, Yuliang

doi:10.1186/s12876-022-02216-x

Cited by 12 publications

(9 citation statements)

References 50 publications

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“…Unconventional lipid parameters such as lipid ratio, RC, and non-HDL-C are hot topics in recent years. These lipid parameters are calculated by conventional lipid parameters according to certain formulas or direct division [ 10 – 12 , 23 – 25 ]. At present, a series of epidemiological studies have been carried out using unconventional lipid parameters as novel markers in the endocrine system, cardio-cerebrovascular system, digestive system, respiratory system, and urinary system diseases [ 8 – 12 , 43 – 48 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the value of conventional and unconventional lipid parameters for predicting the risk of diabetes in a non-diabetic population

et al. 2022

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Background Conventional and unconventional lipid parameters are associated with diabetes risk, the comparative studies on lipid parameters for predicting future diabetes risk, however, are still extremely limited, and the value of conventional and unconventional lipid parameters in predicting future diabetes has not been evaluated. This study was designed to determine the predictive value of conventional and unconventional lipid parameters for the future development of diabetes. Methods The study was a longitudinal follow-up study of 15,464 participants with baseline normoglycemia. At baseline, conventional lipid parameters such as low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) were measured/calculated, and unconventional lipid parameters such as non-HDL-C, remnant cholesterol (RC), LDL/HDL-C ratio, TG/HDL-C ratio, non-HDL/HDL-C ratio, TC/HDL-C ratio and RC/HDL-C ratio were calculated. Hazard ratio (HR) and 95% confidence interval (CI) were estimated by Cox proportional hazard regression adjusting for demographic and diabetes-related risk factors. The predictive value and threshold fluctuation intervals of baseline conventional and unconventional lipid parameters for future diabetes were evaluated by the time-dependent receiver operator characteristics (ROC) curve. Results The incidence rate of diabetes was 3.93 per 1000 person-years during an average follow-up period of 6.13 years. In the baseline non-diabetic population, only TG and HDL-C among the conventional lipid parameters were associated with future diabetes risk, while all the unconventional lipid parameters except non-HDL-C were significantly associated with future diabetes risk. In contrast, unconventional lipid parameters reflected diabetes risk better than conventional lipid parameters, and RC/HDL-C ratio was the best lipid parameter to reflect the risk of diabetes (HR: 6.75, 95% CI 2.40–18.98). Sensitivity analysis further verified the robustness of this result. Also, time-dependent ROC curve analysis showed that RC, non-HDL/HDL-C ratio, and TC/HDL-C ratio were the best lipid parameters for predicting the risk of medium-and long-term diabetes. Conclusions Unconventional lipid parameters generally outperform conventional lipid parameters in assessing and predicting future diabetes risk. It is suggested that unconventional lipid parameters should also be routinely evaluated in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the value of conventional and unconventional lipid parameters for predicting the risk of diabetes in a non-diabetic population

et al. 2022

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“…Abnormal lipid metabolism is the main risk factor for NAFLD [9,10]. Patients with NAFLD usually exhibit atherogenic dyslipidemia, including elevated levels of TG and LDL-C and reduced HDL-C concentrations in traditional lipid indicators [11,12], and exhibit increased RC and non-HDL-C levels, in non-traditional lipid indicators, as well as elevated TC/HDL-C ratio, LDL-C/HDL-C ratio, TG/HDL-C ratio, non-HDL-C, RC, RC/HDL-C ratio and non-HDL-C/HDL-C ratio [13][14][15]. Numerous epidemiological studies have also pointed out that these lipid indicators are very useful biomarkers for the identification of NAFLD [13,14,[16][17][18][19][20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 95%

“…Patients with NAFLD usually exhibit atherogenic dyslipidemia, including elevated levels of TG and LDL-C and reduced HDL-C concentrations in traditional lipid indicators [11,12], and exhibit increased RC and non-HDL-C levels, in non-traditional lipid indicators, as well as elevated TC/HDL-C ratio, LDL-C/HDL-C ratio, TG/HDL-C ratio, non-HDL-C, RC, RC/HDL-C ratio and non-HDL-C/HDL-C ratio [13][14][15]. Numerous epidemiological studies have also pointed out that these lipid indicators are very useful biomarkers for the identification of NAFLD [13,14,[16][17][18][19][20][21][22][23][24][25]. Based on this background, it would be of great clinical importance to further identify the best lipid indicators for identifying patients with NAFLD, which would provide a great convenience for rapid screening of NAFLD.…”

Section: Introductionmentioning

confidence: 95%

“…The calculation formulas of these lipid indicators were shown in Fig. 2 [13,14,18,[20][21][22][23][24][25].…”

Section: Data Collection and Measurementmentioning

confidence: 99%

“…These findings further validated the previous findings and provided a reliable reference for the use of TG as a traditional lipid indicator in NAFLD screening and treatment. Non-traditional lipid indicators have been a research hotspot in recent years, and numerous studies have demonstrated a strong association between non-traditional lipid indicators and NAFLD [13,14,[22][23][24][25], and in general, non-traditional lipid indicators have good application in the risk assessment of NAFLD. However, it is not clear which non-traditional lipid indicators are the most valuable ones for identifying NAFLD.…”

Section: Comparisons With Other Studies and What Does The Current Wor...mentioning

confidence: 99%

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Utility of traditional and non-traditional lipid indicators in the diagnosis of nonalcoholic fatty liver disease in a Japanese population

Kuang²,

Yue³

et al. 2022

Lipids Health Dis

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Background Traditional and non-traditional (TNNT) lipid indicators are known to be closely related to nonalcoholic fatty liver disease (NAFLD). This study’s objective was to compare the degree of associations and diagnostic values of TNNT lipid indicators with NAFLD. Methods Participants were 14,251 Japanese adults who undergoing health checkups, and we measured and calculated 11 lipid indicators, including traditional lipid indicators such as high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride (TG), as well as non-traditional lipid indicators such as TC/HDL-C ratio, LDL-C/HDL-C ratio, TG/HDL-C ratio, non-HDL-C, remnant cholesterol (RC), RC/HDL-C ratio and non-HDL-C/HDL-C ratio. The associations between these lipid indicators and NAFLD were assessed using multivariate logistic regression, and the performance of these lipid indicators in identifying NAFLD was analyzed by receiver operating characteristic (ROC) curves. Results After rigorous adjustment for potential confounders, multivariate logistic regression showed that all TNNT lipid indicators were independently associated with NAFLD, among which the RC/HDL-C ratio and RC had the strongest association with NAFLD. ROC analysis showed that non-traditional lipid indicators were superior to traditional lipid indicators in identifying NAFLD, especially in young adults and females. It is worth mentioning that the RC/HDL-C ratio was the best lipid indicator for identifying NAFLD with an area under the curve (AUC) of 0.82 and an optimal cut-off value of 0.43; in addition, TG/HDL-C ratio also had a high recognition performance for NAFLD. Conclusion Overall, in the Japanese population, non-traditional lipid indicators had a higher diagnostic value for NAFLD compared to traditional lipid indicators, and lipid indicators alone had a lower diagnostic value for NAFLD than the ratio of two lipid indicators, with RC/HDL-C and TG/HDL-C being the best lipid indicators for identifying NAFLD.

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Sex-separated NAFLD/NASH Scores May Improve Predictive Performance

Jeong

Kim

Han

2023

Clinical Gastroenterology and Hepatology

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Remnant cholesterol/high-density lipoprotein cholesterol ratio is a new powerful tool for identifying non-alcoholic fatty liver disease

Cited by 12 publications

References 50 publications

Evaluation of the value of conventional and unconventional lipid parameters for predicting the risk of diabetes in a non-diabetic population

Evaluation of the value of conventional and unconventional lipid parameters for predicting the risk of diabetes in a non-diabetic population

Utility of traditional and non-traditional lipid indicators in the diagnosis of nonalcoholic fatty liver disease in a Japanese population

Sex-separated NAFLD/NASH Scores May Improve Predictive Performance

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