Triglycerides to Total Cholesterol Ratio: An Early Screening Tool for NAFLD in Chinese Populations

Background: Non-alcoholic fatty liver disease(NAFLD) has a high prevalence in the general population worldwide. Both triglycerides (TG) and total cholesterol (TC) are correlated with the prevalence of NAFLD. The study purpose is to determine whether TG/TC is an effective method to screen NAFLD in the general Chinese population.Methods: 93,449 subjects with average age of 43.7 ± 14.3 years were included in this cross-sectional study. Multiple logistic regressions and receiver operator characteristic curve (ROC) analyses were performed.Results: Among these subjects, 16,138 (42.7%) men and 9,591 (17.2%) women were diagnosed with NAFLD. Subjects in the higher quartiles of TG/TC had a higher prevalence of NAFLD. After adjusting multiple confounding factors, the odds ratio (OR) for NAFLD in the highest compared with the lowest quartile was 4.08 (95%CI 3.64, 4.57) in men and 4.65 (95%CI 4.14, 5.21) in women. Moreover, ROC analyses suggested TG/TC showed high diagnostic ability for detecting NAFLD, and the areas under the curves (AUC) in men and women were 0.920 (95%CI 0.917, 0.923) and 0.863 (95%CI 0.859, 0.867), respectively. Furthermore, the diagnostic ability was significantly higher in younger age groups. The AUC in 18–34 and 35–44 years group were 0.943 (95%CI 0.939, 0.946) and 0.921 (95%CI 0.917, 0.925), respectively. Besides, the women and the young people had a greater negative predictive values (90.84% for women, 93.13% for aged 18–34).Conclusion: TG/TC shows a high diagnostic accuracy for identifying NAFLD in young women, providing an important clue to establish a new tool to screen NAFLD particularly in Chinese young females.