Higher non-HDL-cholesterol to HDL-cholesterol ratio is linked to increase in non-alcoholic fatty liver disease: secondary analysis based on a longitudinal study

Background: Non-high-density lipoprotein cholesterol (non-HDLc) to HDLc ratio (non-HDLc/HDLc), is a viable predictor of metabolic syndrome, insulin resistance, and other cardiac diseases. The study aimed to assess whether non-HDLC/HDLc ratio is an independent predictor of NAFLD. Methods: The present study was a longitudinal study, involving 16173 Chinese men and women, aging 14-95 years old, who received a medical check-up program in a health examination Center in China. A total of 16173 initially NAFLD-free non-obese individuals were included, who completed a 5-year follow-up examination in the longitudinal study. NAFLD was defined by ultrasonographic detection of steatosis in the absence of other liver disease. Univariate and multivariate Cox proportional hazards analyses were used to assess the association between nonHDLC/HDLc and NAFLD. ROC curve analysis was performed to compare the predictive value between the nonHDLc/HDLc and the nonHDLc for NAFLD. Results: During the five-year follow-up period, a total of 2322 participants (14.4%) developed NAFLD. The HRs for NAFLD in the longitudinal population were 1.3 (95% CI 1.1 to 1.7) and 1.5 (95% CI 1.1 to 2.0) compared with Q1. AUC values for nonHDLc/HDLc ratios (0.705) were significantly higher than nonHDLc (0.656) (P<0.05), while the cut-off value for the detection of NAFLD was 2.26. Individuals with higher nonHDLc/HDLc ratio had an increased cumulative incidence rate of NAFLD in non-obese individuals. Conclusion: The Non-HDLc ratio/HDLc is an independent predictor of NAFLD. This may help with early identification of high-risk individuals.