Not only baseline but cumulative exposure of remnant cholesterol predicts the development of nonalcoholic fatty liver disease: a cohort study.

Lei Liu; Changfa Wang; Zhongyang HU; Shuwen Deng; Saiqi Yang; Xiaoling Zhu; Yuling Deng; Yaqin Wang

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Not only baseline but cumulative exposure of remnant cholesterol predicts the development of nonalcoholic fatty liver disease: a cohort study.

Author: Lei LIU ¹ ; Changfa WANG ² ; Zhongyang HU ³ ; Shuwen DENG ¹ ; Saiqi YANG ¹ ; Xiaoling ZHU ¹ ; Yuling DENG ¹ ; Yaqin WANG ¹
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1. Health Management Center, The Third Xiangya Hospital, Central South University.
2. General Surgery Department, The Third Xiangya Hospital, Central South University.
3. Department of Neurology, The Third Xiangya Hospital, Central South University.
Publication Type:Journal Article
Keywords: Cohort study; Cumulative exposure; Epidemiology; Nonalcoholic fatty liver disease; Remnant cholesterol
MeSH: Adult; Humans; Cohort Studies; Non-alcoholic Fatty Liver Disease/etiology*; Cholesterol; Proportional Hazards Models; Risk Factors
From:Environmental Health and Preventive Medicine 2024;29():5-5
CountryJapan
Language:English
Abstract: BACKGROUND AND AIM:Remnant cholesterol (remnant-C) mediates the progression of major adverse cardiovascular events. It is unclear whether remnant-C, and particularly cumulative exposure to remnant-C, is associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to explore whether remnant-C, not only baseline but cumulative exposure, can be used to independently evaluate the risk of NAFLD.
METHODS:This study included 1 cohort totaling 21,958 subjects without NAFLD at baseline who underwent at least 2 repeated health checkups and 1 sub-cohort totaling 2,649 subjects restricted to those individuals with at least 4 examinations and no history of NAFLD until Exam 3. Cumulative remnant-C was calculated as a timeweighted model for each examination multiplied by the time between the 2 examinations divided the whole duration. Cox regression models were performed to estimate the association between baseline and cumulative exposure to remnant-C and incident NAFLD.
RESULTS:After multivariable adjustment, compared with the quintile 1 of baseline remnant-C, individuals with higher quintiles demonstrated significantly higher risks for NAFLD (hazard ratio [HR] 1.48, 95%CI 1.31-1.67 for quintile 2; HR 2.07, 95%CI 1.85-2.33 for quintile 3; HR 2.55, 95%CI 2.27-2.88 for quintile 4). Similarly, high cumulative remnant-C quintiles were significantly associated with higher risks for NAFLD (HR 3.43, 95%CI 1.95-6.05 for quintile 2; HR 4.25, 95%CI 2.44-7.40 for quintile 3; HR 6.29, 95%CI 3.59-10.99 for quintile 4), compared with the quintile 1.
CONCLUSION:Elevated levels of baseline and cumulative remnant-C were independently associated with incident NAFLD. Monitoring immediate levels and longitudinal trends of remnant-C may need to be emphasized in adults as part of NAFLD prevention strategy.