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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Translational and Clinical Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1457589
This article is part of the Research Topic New insights: Developments in laboratory testing for the diagnosis and monitoring of endocrine related disorders and metabolic disease View all 6 articles

Elevated Non-HDL-C to HDL-C Ratio as a Marker for NAFLD and Liver Fibrosis Risk: A Cross-Sectional Analysis

Provisionally accepted
Yanyan Xuan Yanyan Xuan 1,2,3Minghui Zhu Minghui Zhu 1*Linzhi Xu Linzhi Xu 1*Shujiao Huangfu Shujiao Huangfu 1*Tongyu Li Tongyu Li 4*Chunbo Liu Chunbo Liu 1*Dongdong Zhou Dongdong Zhou 3*
  • 1 Department of Hospital Infection, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
  • 2 Department of Hepatology, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
  • 3 Department of General Practice,The First Affiliated Hospital of Ningbo University, Ningbo, China
  • 4 Department of Hematology, The First Affiliated Hospital of Ningbo University,, Ningbo, Zhejiang Province, China

The final, formatted version of the article will be published soon.

    Background: Dyslipidemia is a known independent risk factor for Nonalcoholic fatty liver disease (NAFLD). However, the relationship between NAFLD and the serum non-high-density lipoprotein cholesterol (non-HDL-C) to high-density lipoprotein cholesterol (HDL-C) ratio remains unclear. This study examined the association between the non-HDL-C to HDL-C ratio and NAFLD prevalence, including liver steatosis and fibrosis levels in the population. Methods: We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018, including 4798 participants. Liver ultrasound and Transient Elastography (TE) were used to assess fibrosis and steatosis. Adjusted multivariable regression analyses, subgroup analyses based on BMI and sex, and a generalized additive model were employed to investigate the relationship between the non-HDL-C/HDL-C ratio and NAFLD. Results: Among the 4798 participants, 39.27% (n = 1,884) had NAFLD. Significant positive correlations between non-HDL-C/HDL-C and NAFLD risk were found across all models, with sex-stratified analyses indicating higher risk in men. Liver fibrosis was also associated with non-HDL-C/HDL-C ratios. The Receiver operating characteristic (ROC) analysis shows non-HDL-C/HDL-C as a better predictor for NAFLD than non-HDL-C or HDL-C alone. Conclusion: Elevated non-HDL-C/HDL-C levels are independently associated with increased NAFLD and liver fibrosis risk in the American population, suggesting its utility in predicting NAFLD and related liver fibrosis.

    Keywords: NAFLD, Non-high-density lipoprotein cholesterol, High-density lipoprotein cholesterol, NHANES, Fibrosis

    Received: 01 Jul 2024; Accepted: 18 Sep 2024.

    Copyright: © 2024 Xuan, Zhu, Xu, Huangfu, Li, Liu and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Minghui Zhu, Department of Hospital Infection, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
    Linzhi Xu, Department of Hospital Infection, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
    Shujiao Huangfu, Department of Hospital Infection, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
    Tongyu Li, Department of Hematology, The First Affiliated Hospital of Ningbo University,, Ningbo, Zhejiang Province, China
    Chunbo Liu, Department of Hospital Infection, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province, China
    Dongdong Zhou, Department of General Practice,The First Affiliated Hospital of Ningbo University, Ningbo, China

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