Total cholesterol to high-density lipoprotein ratio and nonalcoholic fatty liver disease in a population with chronic hepatitis B

Table 1 Demographic characteristics of the study participants with and without nonalcoholic fatty liver disease

Parameters	Total, n = 183	Non-NAFLD, n = 151	NAFLD, n = 32	P value
Sex (male)	129 (70.5%)	103 (68.2%)	26 (81.3%)	0.14
Age (yr)	45.41 ± 11.59	46.29 ± 12.01	41.25 ± 8.30	< 0.01
BMI (kg/m2)	23.14 ± 2.63	22.73 ± 2.40	25.05 ± 2.82	< 0.01
AST (U/L)	25 (21-32)	25 (21-31)	25.5 (19.75-34.53)	0.75
ALT (U/L)	28 (19-41)	26 (19-38)	39.5 (27-59.5)	< 0.01
γ-GT (U/L)	25 (19-37)	24 (18-32)	39 (25-55.5)	< 0.01
PLT (× 109/L)	208.37 ± 61.13	203.76 ± 63.49	230.09 ± 42.90	0.03
HBsAg (IU/mL)				0.09
≤ 1500	105 (57.4%)	91 (60.3%)	14 (43.8%)
> 1500	78 (42.6%)	60 (39.7%)	18 (56.3%)
CRE (μmol/L)	77.73 ± 17.96	77.14 ± 18.09	80.49 ± 17.28	0.34
UA (μmol/L)	345.20 ± 92.53	332.61 ± 85.18	404.56 ± 103.65	< 0.01
TG (μmol/L)	1.22 ± 0.63	1.08 ± 0.42	1.85 ± 0.99	< 0.01
TC (μmol/L)	4.59 ± 0.98	4.52 ± 0.99	4.89 ± 0.82	0.05
HDL-C (μmol/l)	1.18 ± 0.25	1.19 ± 0.26	1.11 ± 0.14	0.08
LDL-C (μmol/L)	2.72 ± 0.68	2.66 ± 0.65	2.98 ± 0.73	0.02
ApoA1 (g/L)	1.36 ± 0.19	1.36 ± 0.19	1.35 ± 0.15	0.85
ApoB (g/L)	0.91 ± 0.18	0.89 ± 0.17	0.97 ± 0.18	0.02
TC/HDL-C	3.94 ± 0.79	3.83 ± 0.75	4.44 ± 0.77	< 0.01
HBV-DNA (+)	131 (71.6%)	116 (76.8%)	15 (46.9%)	< 0.01
HBeAg (+)	49 (26.8%)	39 (25.8%)	10 (31.3%)	0.52
NAs	168 (91.8%)	144 (95.4%)	24 (75%)	< 0.01

TC/HDL-C: the ratio of TC to HDL-C; NAFLD: Nonalcoholic fatty liver disease; BMI: Body mass index; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; γ-GT: γ-glutamyl transpeptidase; PLT: Platelets; HBsAg: Hepatitis B virus surface antigen; CRE: Creatinine; UA: Uric acid; TG: Triglyceride; TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; ApoA1: Apolipoprotein A1; ApoB: Apolipoprotein B; HBV-DNA (+): Hepatitis B virus DNA > 100 IU/mL; HBeAg (+): Hepatitis B e antigen positive; NAs: Nucleoside analogues.

Table 2 Binary logistic regression of independent risk factors of nonalcoholic fatty liver disease

Parameters	Statistics	OR	(95%CI)	P value
Gender (male)	129 (70.5%)	2.02	(0.78-5.23)	0.15
Age	45.41 ± 11.59	0.96	(0.92-1.00)	0.03
BMI	23.14 ± 2.63	1.40	(1.20-1.63)	< 0.01
AST	25 (21–32)	0.99	(0.98-1.02)	0.99
ALT	28 (19–41)	1.01	(1.00-1.02)	0.04
γ-GT	25 (19–37)	1.02	(1.01-1.04)	< 0.01
PLT	208.37 ± 61.13	1.01	(1.00-1.01)	0.03
HBsAg (IU/mL)				0.09
≤ 1500	105 (57.4%)	0.51	(0.24-1.11)
> 1500	78 (42.6%)	1.95	(0.90-4.22)
CRE	77.73 ± 17.96	1.01	(0.99-1.03)	0.34
UA	345.20 ± 92.53	1.01	(1.00-1.01)	< 0.01
TG	1.22 ± 0.63	6.72	(3.07-14.71)	< 0.01
TC	4.59 ± 0.98	1.46	(1.00-2.15)	0.05
HDL-C	1.18 ± 0.25	0.19	(0.03-1.16)	0.07
LDL-C	2.72 ± 0.68	1.94	(1.11-3.39)	0.02
ApoA1	1.36 ± 0.19	0.81	(0.10-6.44)	0.84
ApoB	0.91 ± 0.18	11.86	(1.37-102.86)	0.03
TC/HDL-C	3.94 ± 0.79	2.55	(1.55-4.19)	< 0.01
HBV-DNA (+)	131 (71.6%)	3.74	(1.70-8.28)	< 0.01
HBeAg (+)	49 (26.8%)	1.31	(0.57-2.00)	0.53
NAs	168 (91.8%)	0.15	(0.05-0.44)	< 0.01

TC/HDL-C: Cholesterol to high-density lipoprotein cholesterol; NAFLD: Non-alcoholic fatty liver disease; BMI: Body mass index; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; γ-GT: γ-glutamyl transpeptidase; PLT: Platelets; HBsAg: Hepatitis B virus surface antigen; CRE: Creatinine; UA: Uric acid; TG: Triglyceride; TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; ApoA1: Apolipoprotein A1; ApoB: Apolipoprotein B; HBV-DNA(+): Hepatitis B virus DNA > 100 IU/mL; HBeAg(+): Hepatitis B e antigen positive; NAs: Nucleoside analogues.

Table 3 Correlation between cholesterol to high-density lipoprotein cholesterol and nonalcoholic fatty liver disease in different models

Variable	Model 1			Model 2			Model 3
	OR	95%CI	P value	OR	95%CI	P value	OR	95%CI	P value
TC/HDL-C	0.94	1.55-4.19)	< 0.01	0.96	(1.52-4.51)	< 0.01	-2.27	(0.01-79.91)	0.5
TC/HDL-C
≤ 3.5	Reference			Reference			Reference
3.5-5	-2.53	(0.01-0.48)	0.01	1.59	(1.10-21.94)	0.04	-0.64	(0.04-6.77)	0.63
> 5	-0.77	(0.14-1.50)	0.2	2.29	(1.60-61.40)	0.01	-1.74	(0.01-14.45)	0.44
P for trend	0.02			0.05			0.73

Model 1 was not adjusted for other pertinent clinical variables.

Model 2 was adjusted according to gender and age.

Model 3 was adjusted according to gender, age, body mass index, aspartate aminotransferase, alanine aminotransferase, γ-glutamyl transpeptidase, platelets, Hepatitis B virus surface antigen, creatinine, uric acid, triglyceride, total cholesterol, High-density lipoprotein cholesterol, Low-density lipoprotein cholesterol, Apolipoprotein A1, Apolipoprotein B, Hepatitis B virus DNA > 100 IU/mL, Hepatitis B e antigen positive, nucleoside analogues. CI: Confidence interval; TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol.

Table 4 The independent correlation between cholesterol to high-density lipoprotein cholesterol and nonalcoholic fatty liver disease by multivariate piecewise linear regression

TC/HDL-C	β	95%CI	P value
< 4.9	5.4	(2.3-12.6)	< 0.01
≥ 4.9	0.5	(0.1-2.2)	0.39

Effect: nonalcoholic fatty liver disease, cause: Total cholesterol High-density lipoprotein cholesterol.

Adjusted: gender, age, Body mass index, aspartate aminotransferase, Alanine aminotransferase, γ-glutamyl transpeptidase, Platelets, Hepatitis B virus surface antigen, Creatinine, Uric acid, Triglyceride, Total cholesterol, High-density lipoprotein cholesterol, Low-density lipoprotein cholesterol, Apolipoprotein A1, Apolipoprotein B, Hepatitis B virus DNA > 100 IU/mL, Hepatitis B e antigen positive, Nucleoside analogues. CI: Confidence interval; TC: Total cholesterol; HDL-C: High-density lipoprotein cholesterol.