Research Article Details

Article ID: A04268
PMID: 33683797
Source: Int J Clin Pract
Title: The association of the steatosis severity, NAFLD fibrosis score and FIB-4 index with atherogenic dyslipidaemia in adult patients with NAFLD: A cross-sectional study.
Abstract: OBJECTIVES: Obesity and dyslipidaemia are the major risk factors for non-alcoholic fatty liver disease (NAFLD), and are known to increase cardiovascular disease (CVD), which is the leading cause of death in NAFLD patients. The present cross-sectional study aimed to investigate associations among severity of hepatic steatosis, NAFLD fibrosis score and atherogenic lipid profile. METHODS: A total of 265 patients with NAFLD confirmed by ultrasonographic findings were included. The NAFLD fibrosis score and the fibrosis-4 (FIB-4) index were used to classify the probability of fibrosis as low, intermediate and high probability. Serum lipids including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured, and then TC/HDL-C, LDL-C/HDL-C, TG/HDL-C and non HDL-C/HDL-C ratios were determined. Fasting blood sugar (FBS), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also assessed. The homeostatic model assessment for insulin resistance (HOMA-IR) was calculated. RESULTS: The severity of hepatic steatosis was positively correlated with TC/HDL-C (r&#160;=&#160;0.29, P&#160;=&#160;.002), LDL-C/HDL-C (r&#160;=&#160;0.32, P&#160;<&#160;.001), TG/HDL-C (r&#160;=&#160;0.36, P&#160;<&#160;.001) and non-HDL-C/HDL-C (r&#160;=&#160;0.24, P&#160;=&#160;.001) ratios. Similarly, these parameters were positively correlated with NAFLD fibrosis score and FIB-4 index (P&#160;<&#160;.05). In addition, alanine aminotransferase and aspartate aminotransferase levels were positively correlated with TG/HDL-C ratio (r&#160;=&#160;0.31, P&#160;=&#160;.003; and r&#160;=&#160;0.27, P&#160;=&#160;.001 respectively). With increasing the severity of hepatic steatosis and NAFLD fibrosis score, the mean of all lipid ratios increased significantly (P&#160;<&#160;.01 and P&#160;<&#160;.05, respectively). Importantly, after controlling for potential confounders including age, gender, physical activity level, body mass index, waist circumference and HOMA-IR, the severity of steatosis, NAFLD fibrosis score and FIB-4 index remained independent predictors of atherogenic lipid profile. CONCLUSIONS: Severity of hepatic steatosis, NAFLD fibrosis score and FIB-4 index were significantly correlated with atherogenic lipid profile. As NAFLD is high among patients with metabolic risk factors for CVD, their dyslipidaemia should be aggressively managed.
DOI: 10.1111/ijcp.14131