Association of the Non-HDL-cholesterol to HDL-cholesterol Rate and the Risk of Non-alcoholic Fatty Liver Disease Among Children and Adolescence: A Retrospective Cohort Study

Abstract

Background: The non-HDL-cholesterol to HDL-cholesterol (non-HDL-c/HDL-c) rate shows a close relationship to multiple dyslipidemia related disease. This paper aims at investigating the association of the non-HDL-c/HDL-c rate and the risk of NAFLD among children and adolescence in China.Methods: In this retrospective cohort study, a total of 7759 eligible children and adolescence (5692 boys, 2067 girls) having received regular medical examination were recruited. We collected anthropometric measurements and laboratory tests data of subjects. The binary logistics regression was employed for the assessment of the associations of the non-HDL-c/HDL-c rate with NAFLD. Sex-specific ROC curve analysis was conducted for comparing the predictive value of non-HDL-c/HDL-c rate, non-HDL-c and HDL-c for NAFLD.Results: The total NAFLD prevalence was 4.36%, higher in boys than that in girls (5.61% vs. 1.9%, P<0.001). It is noteworthy that NAFLD prevalence displayed positive correlation with the non-HDL-c/HDL-c rate（Chi-square test, P<0.001). The binary logistics regression analysis shows that the OR were 8.61 (95% CI = 5.90-12.57, P< 0.001) in the maximum tertiles (maximum non-HDLc/HDLc ratio) compared with the minimum tertiles. When potential confounders were regulated, compared with the minimum tertiles, the OR for the maximum tertiles (OR=3.94, 95%CI=2.33-6.66, P< 0.001) was still significantly higher. AUC values of the non-HDL-c/HDL-c rate ( 0.787 in boys and 0.763in girls) noticeably reached over non-HDL-c (0.719 in boys and 0.661 in girls) and HDL-c (0.726 in boys and 0.732 in girls). Furthermore, the optimal cutoff value of the non-HDL-c/HDL-c rate for NAFLD was 2.475 in boys and 2.695 in girls.Conclusions: The present study indicate that a higher non-HDL-c/ HDL-c rate caused a higher risk of NAFLD among children and adolescence. Moreover, the non-HDL-c/HDL-c rate showed a better predictive value for NAFLD than the non-HDL-c and HDL-c in both boys and girls.