The Association of the Steatosis Severity, Nafld Fibrosis Score and Fib-4 Index With Atherogenic Dyslipidaemia in Adult Patients With Nafld: A Cross-Sectional Study Publisher Pubmed



Tutunchi H^{1, 2} ; Naeini F³ ; Ebrahimimameghani M^{1, 4} ; Mobasseri M² ; Naghshi S³ ; Ostadrahimi A¹ Show Affiliations
Source: International Journal of Clinical Practice Published:2021

Abstract

Objectives: Obesity and dyslipidaemia are the major risk factors for non-alcoholic fatty liver disease (NAFLD), and are known to increase cardiovascular disease (CVD), which is the leading cause of death in NAFLD patients. The present cross-sectional study aimed to investigate associations among severity of hepatic steatosis, NAFLD fibrosis score and atherogenic lipid profile. Methods: A total of 265 patients with NAFLD confirmed by ultrasonographic findings were included. The NAFLD fibrosis score and the fibrosis-4 (FIB-4) index were used to classify the probability of fibrosis as low, intermediate and high probability. Serum lipids including total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were measured, and then TC/HDL-C, LDL-C/HDL-C, TG/HDL-C and non HDL-C/HDL-C ratios were determined. Fasting blood sugar (FBS), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were also assessed. The homeostatic model assessment for insulin resistance (HOMA-IR) was calculated. Results: The severity of hepatic steatosis was positively correlated with TC/HDL-C (r = 0.29, P =.002), LDL-C/HDL-C (r = 0.32, P <.001), TG/HDL-C (r = 0.36, P <.001) and non-HDL-C/HDL-C (r = 0.24, P =.001) ratios. Similarly, these parameters were positively correlated with NAFLD fibrosis score and FIB-4 index (P <.05). In addition, alanine aminotransferase and aspartate aminotransferase levels were positively correlated with TG/HDL-C ratio (r = 0.31, P =.003; and r = 0.27, P =.001 respectively). With increasing the severity of hepatic steatosis and NAFLD fibrosis score, the mean of all lipid ratios increased significantly (P <.01 and P <.05, respectively). Importantly, after controlling for potential confounders including age, gender, physical activity level, body mass index, waist circumference and HOMA-IR, the severity of steatosis, NAFLD fibrosis score and FIB-4 index remained independent predictors of atherogenic lipid profile. Conclusions: Severity of hepatic steatosis, NAFLD fibrosis score and FIB-4 index were significantly correlated with atherogenic lipid profile. As NAFLD is high among patients with metabolic risk factors for CVD, their dyslipidaemia should be aggressively managed. © 2021 John Wiley & Sons Ltd