Correlation of the Lipid Ratios With Hepatic Steatosis and Liver Fibrosis in Non-alcoholic Fatty Liver Disease Patients
Abstract Background: The work intends to investigate the correlation of the lipid ratios to the severity of hepatic steatosis and the presence of liver fibrosis among non-alcoholic fatty liver disease (NAFLD) patients.Methods: Randomly selected 3402 participants were differentiated into the NAFLD (n =2036) and the non-NAFLD group (n =1366) in accordance with the outcomes of the liver ultrasonography. The related anthropometric and biochemical parameters were measured, while the severity of hepatic steatosis and the presence of liver stiffness were appraised by transient elastography.Results: The triglycerides/ high-density lipoprotein cholesterol (TG/HDL-C) and total cholesterol/HDL-C (TC/HDL-C) ratios exhibited a close connection with the severity of hepatic steatosis. Furthermore, higher area under the receiver operator characteristic (AUROC) value for TG/HDL-C than those of TC, TG, LDL-C, HDL-C, TC/HDL-C and non-HDL-C, was observed. Accordingly, the AUROC and optimal cut-off point of TG/HDL-C for NAFLD were 0.771 (95%CI: 0.755-0.787), 1.08 (sensitivity: 72.2 %, specificity: 68.3%), respectively. TG/HDL-C and TC/HDL-C were independent risk factors for the presence of liver fibrosis in NAFLD. Notably, the fact of relatively high AUROC while low AUROC (0.610) values of TG/HDL-C for detecting the presence of liver fibrosis relative to other lipid indexes indicated that it could not function as a desirable indicator of the presence of liver fibrosis in NAFLD.Conclusions: TG/HDL-C can be an independent risk factor for the severity of hepatic steatosis and the presence of liver fibrosis in NAFLD, furthermore, it possesses predictive significance to NAFLD but not to liver fibrosis.