Triglyceride to HDL Cholesterol Ratio for the Identification of MASLD in Obesity: A Liver Biopsy-Based Case-Control Study

• Published in: Nutrients Vol. 16; no. 9; p. 1310
• Main Authors: Martínez-Montoro, José Ignacio, Martínez-Sánchez, María Antonia, Balaguer-Román, Andrés, Fernández-Ruiz, Virginia Esperanza, Hernández-Barceló, José Emilio, Ferrer-Gómez, Mercedes, Frutos, María Dolores, Núñez-Sánchez, María Ángeles, Fernández-García, José Carlos, Ramos-Molina, Bruno
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 27.04.2024
• Subjects: Accuracy; Adult; Biomarkers - blood; Biopsy; Blood cholesterol; Body mass index; Cardiovascular disease; Case-Control Studies; Cholesterol; Cholesterol, HDL - blood; Dyslipidemias - blood; Fatty Liver - blood; Fatty Liver - diagnosis; Female; Gastrointestinal surgery; Glucose; High density lipoprotein; Humans; Inflammation; Insulin resistance; Lipoproteins; Liver; Liver - pathology; liver biopsy; Liver cirrhosis; Liver diseases; Male; Medical research; Medicine, Experimental; Metabolic disorders; metabolic dysfunction-associated steatohepatitis; metabolic dysfunction-associated steatotic liver disease; Metabolic syndrome; Middle Aged; Normal distribution; Obesity; Obesity - blood; Obesity - complications; ROC Curve; Software; Surgery; TG/HDL-C ratio; Triglycerides; Triglycerides - blood; Ultrasonic imaging; Taiwan; Spain; TG/HDL-C ratio; liver biopsy; metabolic dysfunction-associated steatohepatitis; metabolic dysfunction-associated steatotic liver disease; obesity
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu16091310

Associations between dyslipidemia and metabolic dysfunction-associated steatotic liver disease (MASLD) have been reported. Previous studies have shown that the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio may be a surrogate marker of MASLD, assessed by liver ultrasound. However, no studies have evaluated the utility of this ratio according to biopsy-proven MASLD and its stages. Therefore, our aim was to evaluate if the TG/HDL-C ratio allows for the identification of biopsy-proven MASLD in patients with obesity. We conducted a case-control study in 153 patients with obesity who underwent metabolic surgery and had a concomitant liver biopsy. Fifty-three patients were classified as no MASLD, 45 patients as metabolic dysfunction-associated steatotic liver-MASL, and 55 patients as metabolic dysfunction-associated steatohepatitis-MASH. A receiver operating characteristic (ROC) analysis was performed to assess the accuracy of the TG/HDL-C ratio to detect MASLD. We also compared the area under the curve (AUC) of the TG/HDL-C ratio, serum TG, and HDL-C. A higher TG/HDL-C ratio was observed among patients with MASLD, compared with patients without MASLD. No differences in the TG/HDL-C ratio were found between participants with MASL and MASH. The greatest AUC was observed for the TG/HDL-C ratio (AUC 0.747, < 0.001) with a cut-off point of 3.7 for detecting MASLD (sensitivity = 70%; specificity = 74.5%). However, no statistically significant differences between the AUC of the TG/HDL-C ratio and TG or HDL-C were observed to detect MASLD. In conclusion, although an elevated TG/HDL-C ratio can be found in patients with MASLD, this marker did not improve the detection of MASLD in our study population, compared with either serum TG or HDL-C.