Association of residual cholesterol trajectory with the risk of incident non-alcoholic fatty liver disease in a healthy physical check-up study
10.3760/cma.j.cn311282-20240319-00111
- VernacularTitle:健康体检队列人群残粒胆固醇发展轨迹与新发非酒精性脂肪性肝病的相关性研究
- Author:
Yuting SUN
1
;
Xinlei MIAO
;
Guimin TANG
;
Manling HU
;
Xiaoling XIE
;
Shuang LIU
;
Ziping SONG
;
Song LENG
Author Information
1. 大连医科大学附属第二医院健康管理中心，大连 116023
- Publication Type:Journal Article
- Keywords:
Health examination cohort;
Residual cholesterol;
Non-alcoholic fatty liver disease;
Trajectory model
- From:
Chinese Journal of Endocrinology and Metabolism
2024;40(12):1038-1044
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the trajectory of residual cholesterol(RC) in a healthy check-up cohort and explore its correlation with the incidence of non-alcoholic fatty liver disease(NAFLD).Methods:A total of 2 477 participants who met the inclusion criteria in the Health Management Center of the Second Hospital of Dalian Medical University from January 2016 to December 2020 were retrospectively selected to establish a four-year RC trajectory model using the group-based trajectory model(GBTM), and the risk of NAFLD in the RC group was analyzed using Cox proportional hazards regression model. The predictive value of the Cox model was evaluated with a receiver operating characteristic(ROC) curve, and the reliability of the association between RC and NAFLD was verified through sensitivity analysis.Results:Three RC trajectory subgroups were identified low-level RC(79.21%), medium-level RC(19.86%), and high-level RC(0.93%). After 4 years of follow-up, the incidence rate of NAFLD in this cohort was 11.99%, and the incidences of NAFLD in the low-, medium-, and high-RC groups were 10.55%, 16.46%, and 39.13%, respectively. The cumulative incidence of NAFLD increased with follow-up with the highest rate observed in the high-level RC group( χ2=68.026, P<0.001). The results of Cox proportional hazards regression model indicated that the risk of NAFLD incidence in both the high-level and medium-level RC groups was greater than that in the low-level RC group. The areas under ROC curve at the 2nd, 3rd, and 4th years of follow-up were 0.777, 0.778, and 0.720, respectively, suggesting that RC has certain predictive value for new-onset NAFLD. The results were consistent after excluding 166 individuals with diabetes, hypertension, or dyslipidemia. In another sensitivity analysis, higher RC quartiles( Q2, Q3, Q4) were associated with greater NAFLD risk compared to the lowest quartile( Q1). Conclusions:The trajectory of high-level RC is a risk factor for the onset of NAFLD, and the continuous increase of high-level RC value may be an early signal of NAFLD, and timely intervention is recommended to achieve the goal of early prevention of NAFLD.
