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Oxidized low‐density lipoprotein antibodies/high‐density lipoprotein cholesterol ratio is linked to advanced non‐alcoholic fatty liver disease lean patients
Author(s) -
Ampuero Javier,
Ranchal Isidora,
GallegoDurán Rocío,
Pareja María Jesús,
Campo Jose Antonio,
PastorRamírez Helena,
Rico María Carmen,
Picón Rocío,
Pastor Luis,
GarcíaMonzón Carmelo,
Andrade Raúl,
RomeroGómez Manuel
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13335
Subject(s) - steatosis , medicine , fatty liver , odds ratio , gastroenterology , steatohepatitis , body mass index , cholesterol , confidence interval , high density lipoprotein , lipoprotein , endocrinology , disease
Background and Aim A small but significant proportion of patients with normal body mass index show non‐alcoholic fatty liver disease (NAFLD). Oxidized low‐density lipoprotein (LDL) is a powerful immunogenic molecule, which causes oxidative stress and produces antibodies (oxLDL‐ab). We aimed to analyze the role of oxLDL‐ab on histological features in lean‐NAFLD patients. Methods Seventy‐two biopsy‐proven NAFLD patients were included. Lean patients showed body index mass of <30 kg/m 2 . Liver biopsies were assessed by one pathologist blinded to clinical data. Histological features were non‐alcoholic steatohepatitis (NASH), steatosis, hepatocellular ballooning, and liver fibrosis. Metabolic and hepatic profiles were analyzed, and lipid‐lowering medication was recorded. OxLDL‐ab levels were measured by ELISA. OxLDL‐ab‐based lipid indexes analyzed: oxLDL‐ab/total cholesterol ratio; oxLDL‐ab/LDL‐c ratio; oxLDL‐ab/high‐density lipoprotein cholesterol (HDL‐c) ratio; and oxLDL‐ab/oxLDL ratio. Results Lean‐NAFLD patients presented 26.5% (9/34) of NASH. OxLDL‐ab/HDL‐c ratio ( r = 0.570; n = 34; P = 0.001) correlated with NAS score and was the only variable associated with NASH in the multivariate analysis [odds ratio, OR, 1.10 (95% confidence interval, CI: 1.01–1.21); P = 0.039]. Severe steatosis was present in 41.2% (14/34) of lean‐NAFLD patients. OxLDL‐ab/HDL‐c ratio was higher in patients with grade‐III steatosis (54.9 (37.3–124.6)) than those with grade II (37.1 (20.2–71.1)) and grade I (17.7 (13.1‐22.8)) ( P = 0.018). Hepatocellular ballooning was present in 20.6% (7/34) of lean‐NAFLD patients, and OxLDL‐ab/HDL‐c ratio (OR 1.03 [95% CI: 1.01–1.05]; P = 0.050) was independently associated with histological features. OxLDL‐ab/HDL‐c ratio was higher in patients with advanced fibrosis (39.8 (22.9–121.6) vs 17.7 (13.9–30.9); P = 0.025), increasing gradually with the fibrosis stage ( P = 0.042) and remained in the final multivariate model [OR 1.05 (95% CI: 1.00–1.11); P = 0.05]. However, in obese‐NAFLD patients, oxLDL/HDL‐c ratio was not associated with histological features. Conclusions Oxidized low‐density lipoprotein antibodies/high‐density lipoprotein cholesterol ratio could represent an interesting biomarker associated with NASH, hepatocellular ballooning, and liver fibrosis, in lean patients. OxLDL‐ab/HDL‐c could play an important role for distinguishing patients with and without NAFLD complications.