Total cholesterol to high-density lipoprotein cholesterol ratio is a significant predictor of nonalcoholic fatty liver: Jinchang cohort study

Abstract

BackgroundSome studies found out that TC/HDL-C ratio is a predictor of Cardiovascular disease (CVD) and Nonalcoholic fatty liver (NAFLD) is related to CVD. And some researches have already studied that Apolipoprotein B to Apolipoprotein A1 ratio (ApoB/ApoA1) and Triglyceride to High-density lipoprotein cholesterol ratio (TG/HDL-C) were both related with CVD and NAFLD, but few studied the association between TC/HDL-C ratio and NAFLD. So, we suspected the ratio was also related to NAFLD. The research aims to study the predictive value of TC/HDL-C to NAFLD and to help the early detection of NAFLD.MethodsBased on the Jinchang Cohort, the study contained 32,121 participants. We assessed the incidence of NAFLD by the quartiles of TC, HDL-C and TC/HDL-C. Then, the does-response relationship between these indicators and the risk of NAFLD was obtained. Finally, the receiver operator characteristic curve (ROC) was applied to decide the predictive value of TC/HDL-C.ResultsAmong the study participants, the cumulative incidence of NAFLD was 6.30% and the rate of dyslipidemia was 40.37%. The biochemical indicators of NAFLD had a difference with general population. The incidence of NAFLD raised with the quartiles of TC, TG and LDL-C raising, while decreased with the HDL-C′ quartiles raising. After controlling confounding factors, TC and TC/HD-C had a positive relationship with NAFLD, while HDL-C had the opposite. Finally, the ROC analysis showed the area under the curve (AUC) of TC/HDL-C (0.645) was greater than TC (0.554), HDL-C (0.627) and Apolipoprotein B to Apolipoprotein A1 (ApoB/ApoA1) (0.613).ConclusionsThe TC/HDL-C ratio has significant predictive value to NAFLD.Electronic supplementary materialThe online version of this article (10.1186/s12944-019-0984-9) contains supplementary material, which is available to authorized users.

The Comparation of Anthropometric and Metabolic Indices in the Regulation and Prediction of Fatty Liver: a population-based cross-sectional study in China

“…Some studies thought that the visceral adiposity was the main adipose depot responsible for FL and was associated with FL in a dose-dependent manner in a cohort study [30]. WC, WHR and BMI have been proved and used in many clinical trials as an indicator of the severity of fatty liver disease [19,22]. BFM and VFA are often reported markers in athletes related articles or are used to explore the relationship between insulin resistance and excessive visceral fat accumulation [31,32].…”

“…BFM and VFA are often reported markers in athletes related articles or are used to explore the relationship between insulin resistance and excessive visceral fat accumulation [31,32]. Additionally, elevated data strongly suggests that advanced blood lipids, blood pressure and blood sugar could also be lead to more severe histological changes and poorer clinical outcomes [14,22,33]. Once FL is established, insulin resistance can promote the progression to the more severe state of liver endangerment like non-alcoholic steatohepatitis.…”

“…Some studies found regional distribution of lean and fat mass may in uence the development of FL and suggested that abdominal fat are risk factors for fatty liver and more advanced fatty liver related brosis [7,11]. In recent years, several anthropometric or metabolic indices had been reported to be associated with FL in both cross-sectional and cohort studies [16][17][18][19][20][21][22][23]. However, most existing studies mainly focused on common indices (such as waist, body mass index, triglyceride and blood glucose).…”

Triglycerides to Total Cholesterol Ratio: An Early Screening Tool for NAFLD in Chinese Populations

“…However, the diagnostic ability based on a single lipid parameter was not enough [15]. Recent studies based on ratio, as such triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) [15], total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) [16], and apolipoprotein B/AI (ApoB/A I) [17], explored the diagnostic value for NAFLD, and the AUC of TG/HDL-C is signi cantly higher than that based on a single lipid parameter.…”

“…To date, there are limited evidence of the indexes on the ability of identifying NAFLD. Furthermore, among these indexes, the highest AUC of those was only 0.85 [15,16,17]. It is utmost important to set a new index for accurately identifying individuals at high risk of NAFLD in clinical practice.…”