Correlation of triglyceride to high-density lipoprotein cholesterol ratio with nonalcoholic fatty liver disease among the non-obese Chinese population with normal blood lipid levels: a retrospective cohort research

BACKGROUND: Although nonalcoholic fatty liver disease (NAFLD) is commonly seen in metabolic abnormalities patients, NAFLD is also occurred in the non-obese individuals. The ratio of triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) is considered as a predictive factor of NAFLD. However, it is still difficult to confirm the correlation of TG/HDL-C ratio with NAFLD among non-obese Chinese people with normal blood lipid levels. In our study, it is aimed to analyze the correlation of TG/HDL-C ratio with NAFLD among non-obese Chinese population without dyslipidemia. METHODS: In the retrospective cohort study, 9838 non-obese subjects who were free of NAFLD were enrolled. NAFLD was diagnosed by ultrasonography. RESULTS: During the median follow-up period of 2.9 years, cumulative incidence of NAFLD in non-obesity individuals was 8.69% among the overall population; meanwhile, its incidence was gradually enhanced across the quartiles of TG/HDL-C ratio (0.61, 1.28, 2.55 and 4.25% respectively). Then the multivariate factors were adjusted. The multivariate cox regression analysis results showed that the hazard ratio of NAFLD in higher quartiles (Q2-Q4) was 2.10 (1.33–3.32), 3.11 (2.03–4.75) and 3.40 (2.24–5.17), respectively. Besides, the area under receiver operator characteristic curve (AUC) of TG/HDL-C ratio in the male was 0.70 (0.68–0.72) and 0.72 (0.70–0.75) in the female. The final values were dramatically larger than the other lipid index. CONCLUSION: There is an independent relationship between TG/HDL-C and NAFLD among non-obese Chinese population without dyslipidemia, and TG/HDL-C may be used as a better predictor for NAFLD.