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Association between remnant lipoprotein cholesterol levels and risk of non-alcoholic fatty liver disease in non-obese populations: a Chinese longitudinal prospective cohort study
OBJECTIVES: The association between remnant lipoprotein cholesterol (RLP-C) levels and the incidence of non-alcoholic fatty liver disease (NAFLD) is unclear, especially in non-obese populations. SETTING: We used data from a health assessment database. The assessment was conducted at the Wenzhou Medi...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10163498/ https://www.ncbi.nlm.nih.gov/pubmed/37147088 http://dx.doi.org/10.1136/bmjopen-2022-069440 |
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author | Miao, Yanju Tao, Hong |
author_facet | Miao, Yanju Tao, Hong |
author_sort | Miao, Yanju |
collection | PubMed |
description | OBJECTIVES: The association between remnant lipoprotein cholesterol (RLP-C) levels and the incidence of non-alcoholic fatty liver disease (NAFLD) is unclear, especially in non-obese populations. SETTING: We used data from a health assessment database. The assessment was conducted at the Wenzhou Medical Center from January 2010 to December 2014. The patients were divided into low, middle and high RLP-C groups according to tertiles of RLP-C, and baseline metabolic parameters were compared among the three groups. Kaplan-Meier analysis and Cox proportional hazards regression were used to evaluate the relationship between RLP-C and NAFLD incidence. Additionally, sex-specific associations between RLP-C and NAFLD were examined. PARTICIPANTS: 16 173 non-obese participants from the longitudinal healthcare database. OUTCOME MEASURE: NAFLD was diagnosed using abdominal ultrasonography and clinical history. RESULTS: Participants with higher RLP-C levels tended to have higher blood pressure, liver metabolic index and lipid metabolism index than those with middle or low RLP-C (p<0.001). During the 5-year follow-up period, 2322 (14.4%) participants developed NAFLD. Participants with high and middle RLP-C levels were at a higher risk of developing NAFLD, even after adjusting for age, sex, body mass index and main metabolic parameters (HR 1.6, 95% CI 1.3, 1.9, p<0.001; and HR 1.3, 95% CI 1.1, 1.6, p=0.01, respectively). The effect was consistent in subgroups of different ages, systolic blood pressures and alanine aminotransferase levels, except for sex and direct bilirubin (DBIL). These correlations, beyond traditional cardiometabolic risk factors, were stronger in males than females (HR 1.3 (1.1, 1.6) and HR 1.7 (1.4, 2.0), p for interaction 0.014 for females and males, respectively). CONCLUSIONS: In non-obese populations, higher RLP-C levels indicated a worse cardiovascular metabolic index. RLP-C was associated with the incidence of NAFLD, independent of the traditional risk factors of metabolism. This correlation was more substantial in the male and low DBIL subgroups. |
format | Online Article Text |
id | pubmed-10163498 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-101634982023-05-07 Association between remnant lipoprotein cholesterol levels and risk of non-alcoholic fatty liver disease in non-obese populations: a Chinese longitudinal prospective cohort study Miao, Yanju Tao, Hong BMJ Open Diabetes and Endocrinology OBJECTIVES: The association between remnant lipoprotein cholesterol (RLP-C) levels and the incidence of non-alcoholic fatty liver disease (NAFLD) is unclear, especially in non-obese populations. SETTING: We used data from a health assessment database. The assessment was conducted at the Wenzhou Medical Center from January 2010 to December 2014. The patients were divided into low, middle and high RLP-C groups according to tertiles of RLP-C, and baseline metabolic parameters were compared among the three groups. Kaplan-Meier analysis and Cox proportional hazards regression were used to evaluate the relationship between RLP-C and NAFLD incidence. Additionally, sex-specific associations between RLP-C and NAFLD were examined. PARTICIPANTS: 16 173 non-obese participants from the longitudinal healthcare database. OUTCOME MEASURE: NAFLD was diagnosed using abdominal ultrasonography and clinical history. RESULTS: Participants with higher RLP-C levels tended to have higher blood pressure, liver metabolic index and lipid metabolism index than those with middle or low RLP-C (p<0.001). During the 5-year follow-up period, 2322 (14.4%) participants developed NAFLD. Participants with high and middle RLP-C levels were at a higher risk of developing NAFLD, even after adjusting for age, sex, body mass index and main metabolic parameters (HR 1.6, 95% CI 1.3, 1.9, p<0.001; and HR 1.3, 95% CI 1.1, 1.6, p=0.01, respectively). The effect was consistent in subgroups of different ages, systolic blood pressures and alanine aminotransferase levels, except for sex and direct bilirubin (DBIL). These correlations, beyond traditional cardiometabolic risk factors, were stronger in males than females (HR 1.3 (1.1, 1.6) and HR 1.7 (1.4, 2.0), p for interaction 0.014 for females and males, respectively). CONCLUSIONS: In non-obese populations, higher RLP-C levels indicated a worse cardiovascular metabolic index. RLP-C was associated with the incidence of NAFLD, independent of the traditional risk factors of metabolism. This correlation was more substantial in the male and low DBIL subgroups. BMJ Publishing Group 2023-05-05 /pmc/articles/PMC10163498/ /pubmed/37147088 http://dx.doi.org/10.1136/bmjopen-2022-069440 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Diabetes and Endocrinology Miao, Yanju Tao, Hong Association between remnant lipoprotein cholesterol levels and risk of non-alcoholic fatty liver disease in non-obese populations: a Chinese longitudinal prospective cohort study |
title | Association between remnant lipoprotein cholesterol levels and risk of non-alcoholic fatty liver disease in non-obese populations: a Chinese longitudinal prospective cohort study |
title_full | Association between remnant lipoprotein cholesterol levels and risk of non-alcoholic fatty liver disease in non-obese populations: a Chinese longitudinal prospective cohort study |
title_fullStr | Association between remnant lipoprotein cholesterol levels and risk of non-alcoholic fatty liver disease in non-obese populations: a Chinese longitudinal prospective cohort study |
title_full_unstemmed | Association between remnant lipoprotein cholesterol levels and risk of non-alcoholic fatty liver disease in non-obese populations: a Chinese longitudinal prospective cohort study |
title_short | Association between remnant lipoprotein cholesterol levels and risk of non-alcoholic fatty liver disease in non-obese populations: a Chinese longitudinal prospective cohort study |
title_sort | association between remnant lipoprotein cholesterol levels and risk of non-alcoholic fatty liver disease in non-obese populations: a chinese longitudinal prospective cohort study |
topic | Diabetes and Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10163498/ https://www.ncbi.nlm.nih.gov/pubmed/37147088 http://dx.doi.org/10.1136/bmjopen-2022-069440 |
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