The albumin-to-alkaline phosphatase ratio as an independent predictor of future non-alcoholic fatty liver disease in a 5-year longitudinal cohort study of a non-obese Chinese population

Abstract

Background The albumin-to-alkaline phosphatase ratio (AAPR) is a newly developed index of liver function, but its association in patients with non-alcoholic fatty liver disease (NAFLD) has not been established. The aim of this study was to investigate the association between the AAPR and NAFLD in a non-obese Chinese population. Methods The study included 10,749 non-obese subjects without NAFLD at baseline and divided them into quintiles according to the AAPR. A Cox multiple regression model was used to examine the association between the AAPR and its quintiles and the incidence of NAFLD. Results The average age of the study population was 43.65 ± 15.15 years old. During the 5-year follow-up, 1860 non-obese subjects had NAFLD events. In the Cox multiple regression model, after adjusting the model according to important risk factors, the AAPR and NAFLD risk were independently correlated, and with a gradual increase in the AAPR, the NAFLD risk decreased gradually (HR: 0.61, 95% CI: 0.47, 0.81; P-trend< 0.0001). Additionally, there were significant interactions between the AAPR and BMI, blood pressure and lipids (P-interaction < 0.05). Stratified analysis showed that the risk of AAPR-related NAFLD decreased in people with normal blood pressure and lipid levels, while the risk of AAPR-related NAFLD increased abnormally in people who were underweight. Conclusions This longitudinal cohort study provides the first evidence that the AAPR is an independent predictor of future NAFLD events in non-obese people. For non-obese people with a low AAPR, especially those with BMI < 18.5 kg/m2, more attention should be given to the management of risk factors for NAFLD to prevent future NAFLD.

Higher serum uric acid to HDL-cholesterol ratio is associated with onset of non-alcoholic fatty liver disease in a non-obese Chinese population with normal blood lipid levels

“…Recently, Zhao et al [11] performed step-to-multiple logistic regression analysis on 1000 samples and obtained the NAFLD index (NFI), which includes ALT/ AST and TG, as a clinical scoring tool for predicting NAFLD. Accordingly, we compared the predictive value of UHR for NAFLD onset in non-obese adults to other indicators recently proposed in the literature [34][35][36][37][38].…”

Usefulness of the triglyceride glucose-body mass index in evaluating nonalcoholic fatty liver disease: insights from a general population

“…Step two (association analysis of TyG-BMI and NAFL D): Before establishing the multivariable logical regression model, the researchers first checked the collinearity between the covariables (Supplementary Table 1) [21]. Next, the correlation between the baseline data and TyG-BMI was checked by linear regression (Supplementary Table 2) [22]. The variables significantly related to TyG-BMI were considered auxiliary factors of the relationship between the two.…”

A Cross-Sectional Pilot Study on Food Intake Patterns Identified from Very Short FFQ and Metabolic Factors Including Liver Function in Healthy Japanese Adults

“…High levels of ALP and LAP without an increase in the bilirubin concentration might reflect lipid accumulation. Recently, ALP has attracted attention as an independent predictor of NAFLD [34][35][36]. As we did not measure ALP by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) method, our data might include intestinal ALP.…”