Research Article Details

Article ID: A13040
PMID: 30170220
Source: Atherosclerosis
Title: Cholesterol efflux capacity is impaired in subjects with an elevated Fatty Liver Index, a proxy of non-alcoholic fatty liver disease.
Abstract: BACKGROUND AND AIMS: Non-alcoholic fatty liver disease (NAFLD) parallels the obesity epidemic and associates with components of the metabolic syndrome (MetS). Cholesterol efflux capacity (CEC) represents a key metric of high density lipoprotein (HDL) function which may predict atherosclerotic cardiovascular disease (CVD). Here we assessed the relationship of CEC with NAFLD. METHODS: CEC was determined from THP-1 macrophage foam cells towards apolipoprotein B-depleted plasma among 639 subjects (454 men; 36 subjects with type 2 diabetes mellitus (T2D); 226 with MetS), participating in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study. A Fatty Liver Index (FLI)&#8239;&#8805;&#8239;60 was used as a proxy of NAFLD. RESULTS: 372 participants had a FLI &#8805;60, which coincided with an increased prevalence of T2D and MetS (p&#8239;=&#8239;0.009 and p&#8239;<&#8239;0.001), as well as with central obesity, higher systolic blood pressure, glucose, total cholesterol, triglycerides and high sensitivity C-reactive protein (hsCRP), and decreased HDL cholesterol (p&#8239;<&#8239;0.001 for each). In multivariable linear regression analyses, CEC was inversely associated with an elevated FLI, when taking account of clinical covariates (fully adjusted model: &#946;&#8239;=&#8239;-0.091, p&#8239;=&#8239;0.043), and alternatively when taking account of systolic blood pressure, waist/hip ratio, glucose, HDL cholesterol, triglycerides and hsCRP (fully adjusted model: &#946;&#8239;=&#8239;-0.103, p&#8239;=&#8239;0.034). CONCLUSIONS: Impaired CEC is associated with NAFLD, as inferred from a FLI&#8805;60, even when taking account of lower HDL cholesterol and enhanced low-grade chronic inflammation. Reduced CEC could contribute to accelerated CVD in NAFLD patients.
DOI: 10.1016/j.atherosclerosis.2018.07.028