Why the study?
The association between the non-HDL to HDL cholesterol ratio and metabolic dysfunction-associated steatotic liver disease, particularly in obesity and type 2 diabetes, needed evaluation.
Does a higher non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) correlate with an increased prevalence of MASLD in adults?
Does a higher non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) correlate with an increased prevalence of MASLD in adults?
NHHR is a strong, independent predictor of MASLD prevalence, suggesting its potential utility as a simple, noninvasive screening biomarker, particularly in populations with obesity or type 2 diabetes.
Supports NHHR as a potential MASLD marker in high-risk adults; hypothesis-generating and requires prospective validation before clinical adoption.
INTRODUCTION: This cross-sectional study was conducted to examine the association between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and metabolic dysfunction-associated steatotic liver disease (MASLD), particularly in populations with obesity and type 2 diabetes (T2D). METHODS: The analysis included 3784 participants who were 20 years and older, using data from the National Health and Nutrition Examination Survey (NHANES) 2017-2018. The prevalence of MASLD was determined using multivariable logistic regression analysis, which calculated odds ratios (ORs) and 95% confidence intervals (CIs). Conducted was an analysis employing a smooth curve fitting approach to explore the potential nonlinear association between NHHR and MASLD. Subgroup analyses were performed based on age, sex, body mass index (BMI) and T2D status to evaluate the robustness of the results, with interaction tests conducted. RESULTS: NHHR showed a consistently positive association with MASLD across all models. In the fully adjusted model, compared with the low NHHR group, participants in the middle and high NHHR group were associated with higher prevalence of MASLD (OR = 1.51, 95%CI = 1.25-1.83, p < 0.001, OR = 1.97, 95%CI = 1.62-2.41, p < 0.001, respectively). This positive relationship was significant across all subgroups, confirming a robust association between NHHR and MASLD. CONCLUSIONS: This cross-sectional study found a significant linear positive relationship between NHHR and MASLD, which remained significant across different age, sex, BMI and T2D groups. These findings suggest that NHHR may have the potential to serve as a predictor for screening MASLD in populations with obesity or T2D.
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Ma et al. (2025) studied this question.
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