The Journal of Practical Medicine >
Association between residual cholesterol and metabolic associated fatty liver disease risk at different triglyceride levels
Received date: 2025-06-27
Online published: 2025-09-05
Objective This study aims to investigate the association between remnant cholesterol (RC) and the risk of metabolic-associated fatty liver disease (MAFLD) under the optimal triglyceride (TG) levels recommended by different guidelines. Methods The data were derived from the annual physical examinations of elderly people aged 65 and above in a community in 2023. Regression analysis was used to evaluate the association between RC and MAFLD risk. According to the TG normal level (< 1.7 mmol/L) recommended by the Chinese Lipid Management Consensus and the TG ideal target (< 1.2 mmol/L) proposed by the European Atherosclerosis Society, the individuals were divided into subgroups with different TG levels to explore the association between RC and MAFLD risk in each subgroup. Results A total of 2,800 elderly individuals aged 65 and above were included in this study. The proportion of the individuals meeting the diagnostic criteria for MAFLD was 20.85%, and RC was identified as an independent risk factor for MAFLD (P < 0.001). In the elderly individuals with TG< 1.7 mmol/L, RC level was not significantly associated with MAFLD risk (P = 0.888). In contrast, in the elderly individuals with TG ≥ 1.7 mmol/L, RC level was significantly and positively correlated with MAFLD risk (P < 0.001). Interaction tests revealed no significant interaction between the stratification factor and the effect size of RC (P = 0.115). In the elderly individuals with TG< 1.2 mmol/L, RC level was not associated with MAFLD risk(P = 0.505), while in the elderly individuals with TG ≥ 1.2 mmol/L, RC level was significantly associated with MAFLD risk (P < 0.001). Interaction tests showed a significant interaction between the stratification factor and the effect size of RC (P = 0.011). Conclusion RC is an independent risk factor for MAFLD in older individuals. To reduce the risk of MAFLD related to RC in the elderly, a triglyceride level of < 1.2 mmol/L can serve as a reference for identifying early-stage risk.
Lili SU , Nuo LI , Wei FANG , Menghua CHEN , Sina QIN , Yegui YANG . Association between residual cholesterol and metabolic associated fatty liver disease risk at different triglyceride levels[J]. The Journal of Practical Medicine, 2025 , 41(17) : 2676 -2682 . DOI: 10.3969/j.issn.1006-5725.2025.17.010
| [1] | LóPEZ-GONZáLEZ á A, MARTíNEZ-ALMOYNA RIFá E, OLIVEIRA H P, et al. Association Between Sociodemographic Variables, Healthy Habits, and Stress with Risk Scales for Liver Disease Associated with Metabolic Dysfunction [J]. Life (Basel), 2025, 15(1):116. doi:10.3390/life15010116 |
| [2] | LV D, WANG Z, LIU H, et al. Predictive Value of the Triglyceride-Glucose Index for Metabolic-Associated Fatty Liver Disease in Individuals with Different Metabolic Obese Phenotypes [J]. Diabetes Metab Syndr Obes, 2025, 18:125-133. doi:10.2147/dmso.s500042 |
| [3] | CHEN Y, ZHAO X. The mediating role of insulin resistance in the association between inflammatory score and MAFLD:NHANES 2017-2018 [J]. Immun Inflamm Dis, 2024, 12(10):e70035. doi:10.1002/iid3.70035 |
| [4] | INAMINE S, KAGE M, AKIBA J, et al. Metabolic dysfunction-associated fatty liver disease directly related to liver fibrosis independent of insulin resistance, hyperlipidemia, and alcohol intake in morbidly obese patients [J]. Hepatol Res, 2022, 52(10):841-858. doi:10.1111/hepr.13808 |
| [5] | HOU M, GU Q, CUI J, et al. Proportion and clinical characteristics of metabolic-associated fatty liver disease and associated liver fibrosis in an urban Chinese population [J]. Chin Med J (Engl), 2025, 138(7):829-837. doi:10.1097/cm9.0000000000003141 |
| [6] | RéMOND D, SHAHAR D R, GILLE D, et al. Understanding the gastrointestinal tract of the elderly to develop dietary solutions that prevent malnutrition [J]. Oncotarget, 2015, 6(16):13858-13898. doi:10.18632/oncotarget.4030 |
| [7] | GARIBALLA S E, SINCLAIR A J. Nutrition, ageing and ill health [J]. Br J Nutr, 1998, 80(1):7-23. doi:10.1017/s000711459800172x |
| [8] | STüRZEBECHER P E, KATZMANN J L, LAUFS U. What is 'remnant cholesterol'? [J]. Eur Heart J, 2023, 44(16):1446-1448. doi:10.1093/eurheartj/ehac783 |
| [9] | MILLER M, STONE N J, BALLANTYNE C, et al. Triglycerides and cardiovascular disease: A scientific statement from the American Heart Association [J]. Circulation, 2011, 123(20):2292-2333. doi:10.1161/cir.0b013e3182160726 |
| [10] | NORDESTGAARD B G. Triglyceride-Rich Lipoproteins and Atherosclerotic Cardiovascular Disease: New Insights From Epidemiology, Genetics, and Biology [J]. Circ Res, 2016, 118(4):547-563. doi:10.1161/circresaha.115.306249 |
| [11] | VARBO A, NORDESTGAARD B G. Remnant cholesterol and risk of ischemic stroke in 112,512 individuals from the general population [J]. Ann Neurol, 2019, 85(4):550-559. doi:10.1002/ana.25432 |
| [12] | KALTOFT M, LANGSTED A, NORDESTGAARD B G. Triglycerides and remnant cholesterol associated with risk of aortic valve stenosis:Mendelian randomization in the Copenhagen General Population Study [J]. Eur Heart J, 2020, 41(24):2288-2299. doi:10.1093/eurheartj/ehaa172 |
| [13] | GINSBERG H N, PACKARD C J, CHAPMAN M J, et al. Triglyceride-rich lipoproteins and their remnants: Metabolic insights, role in atherosclerotic cardiovascular disease, and emerging therapeutic strategies-a consensus statement from the European Atherosclerosis Society [J]. Eur Heart J, 2021, 42(47):4791-4806. doi:10.1093/eurheartj/ehab551 |
| [14] | 梁宝怡,沈天然,郑秋潼,等. 老年人群残余胆固醇与代谢相关脂肪性肝病的关联性和剂量反应关系的研究[J]. 现代预防医学, 2025, 52(3):520-525. |
| [15] | HAO X, LI D, HUANG X, et al. Remnant cholesterol, a potential risk factor of metabolic dysfunction-associated fatty liver disease [J]. Nutr Metab (Lond), 2025, 22(1):13. doi:10.1186/s12986-025-00898-0 |
| [16] | 王增武, 刘静, 李建军,等. 中国血脂管理指南(2023年)[J]. 中国循环杂志, 2023, 38(3): 237-271. |
| [17] | 中华医学会肝病学分会脂肪肝和酒精性肝病学组中国医师协会脂肪性肝病专家委员会 非酒精性脂肪性肝病防治指南(2018年更新版) [J]. 临床肝胆病杂志, 2018, 34(5): 947-957. |
| [18] | ESLAM M, FAN J G, YU M L, et al. The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease [J]. Hepatol Int, 2025, 19(2):261-301. |
| [19] | 肖定洪, 梁春耕, 徐辉,等. 上海市老年人群代谢相关脂肪性肝病与体质相关性的横断面调查 [J]. 中医杂志, 2022, 63 (16): 1559-1565. |
| [20] | 蔡秀蕙, 丘世华, 陈丽玉. 2型糖尿病患者残余胆固醇与代谢相关脂肪性肝病相关性的研究[J].中国糖尿病杂志,2023, 31(1):31-36. |
| [21] | 郭彩云, 刘师伟. 非传统脂质参数与2型糖尿病合并冠心病的关系 [J]. 中西医结合心脑血管病杂志, 2024, 22 (12): 2196-2202. |
| [22] | 巨名飞, 刘超, 刘佳梅,等. 急性冠状动脉综合征患者残余胆固醇水平与冠状动脉狭窄严重程度的相关性 [J]. 实用医学杂志, 2023, 39(1): 71-75. |
| [23] | 陶赟, 褚少朋, 俞娟,等. 载脂蛋白C3-高脂血症与内皮细胞功能障碍的重要分子 [J]. 现代生物医学进展, 2017, 17(22): 4382-4386+4337. |
| [24] | 杨滢, 谭秋晓, 李荔,等. 血清载脂蛋白C3在胰岛素抵抗疾病中的研究进展 [J]. 实用医学杂志, 2020, 36(5): 699-704. |
| [25] | 程翔, 苏冠华 2024 血脂异常药物治疗新进展[J]. 临床心血管病杂志, 2025, 41(2): 89-93. |
| [26] | EMMA M R, GIANNITRAPANI L, CABIBI D, et al. Hepatic and circulating levels of PCSK9 in morbidly obese patients:Relation with severity of liver steatosis [J]. Biochim Biophys Acta Mol Cell Biol Lipids, 2020, 1865(12):158792. doi:10.1016/j.bbalip.2020.158792 |
| [27] | 严妍,邓紫薇,仇成凤. PCSK9联合乳酸及SOFA评分对脓毒症患者死亡风险的预测价值[J]. 天津医药, 2025, 53(7):684-688. |
| [28] | 何乃琪, 赵雪珊, 徐倩,等. 氧化低密度脂蛋白通过PCSK9/LRP1信号途径促神经细胞凋亡的双向调节 [J]. 生物化学与生物物理进展, 2024, 51(4): 944-958 |
| [29] | 李安琪, 赵佩然, 赵玉强, 等. 固醇调节元件结合蛋白(SREBP)在非酒精性脂肪性肝病中的作用机制及治疗靶点[J]. 临床肝胆病杂志, 2024, 40(7):1459-1465. |
| [30] | GE J, LI G, CHEN Z, et al. Kaempferol and nicotiflorin ameliorated alcohol-induced liver injury in mice by miR-138-5p/SIRT1/FXR and gut microbiota [J]. Heliyon, 2023, 10(1):e23336. doi:10.1016/j.heliyon.2023.e23336 |
/
| 〈 |
|
〉 |