Table1_Elevated non-HDL-C to HDL-C ratio as a marker for NAFLD and liver fibrosis risk: a cross-sectional analysis.docx

BackgroundDyslipidemia 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.MethodsWe 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.ResultsAmong 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.ConclusionElevated 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.

背景：非酒精性脂肪性肝病（NAFLD）已知为一种独立的危险因素。然而，NAFLD与血清非高密度脂蛋白胆固醇（non-HDL-C）与高密度脂蛋白胆固醇（HDL-C）比值之间的关系尚不明确。本研究旨在探讨non-HDL-C/HDL-C比值与NAFLD患病率之间的关联，包括人群中的肝脂肪变性及纤维化程度。方法：本研究采用2017-2018年全国健康与营养调查（NHANES）的数据，纳入4798名参与者。通过肝脏超声和瞬时弹性成像（TE）技术评估纤维化和脂肪变性。采用调整多变量回归分析、基于体重指数和性别的亚组分析以及广义加性模型来研究non-HDL-C/HDL-C比值与NAFLD之间的关联。结果：在4798名参与者中，39.27%（n = 1,884）患有NAFLD。在所有模型中，non-HDL-C/HDL-C与NAFLD风险之间均存在显著的正相关关系，性别分层分析显示男性风险更高。肝脏纤维化也与non-HDL-C/HDL-C比值相关。受试者工作特征（ROC）分析显示，non-HDL-C/HDL-C作为NAFLD预测因子优于单独的non-HDL-C或HDL-C。结论：非高密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值升高独立地与美国人群中NAFLD和肝脏纤维化风险增加相关，提示其在预测NAFLD及相关肝脏纤维化方面的应用价值。