Correlative Analysis of Atherogenic Dyslipidemia among the Patients with Non Alcoholic Fatty Liver Disease Visiting Tertiary Care Center

Abstract

Introduction: Non-alcoholic fatty liver disease (NAFLD) is one of the most prominent causes of chronic liver disease. It is known that dyslipidemia in NAFLD patients may have more severe atherogenic potential with high triglyceride and low density lipoprotein (LDL) as well as less high density lipoprotein (HDL) level.
 Objective: To determine the atherogenic dyslipidemia and associated factors among patients with NAFLD, Visiting Tertiary Care Center
 Methodology: Prospective cross-sectional study was conducted at Dhulikhel Hospital-Kathmandu University Hospital (DH-KUH) from January, 2016 to December, 2016. All the patients (n= 973) diagnosed to have fatty liver during this study period were initially enrolled in this study. Patients were further asked to fill up the questioner. Out of total 973 cases, 169 patients were identified as NAFLD. Fasting blood sample and anthropometric measurements (BMI, WHR) were taken. After adjusting exclusion criteria, refusal to participate and dropout from the study, 101 patients and 92 apparently healthy age sex matched control group was selected for the study. Blood sugar level and lipid profile were analyzed to assess the risk of athrogenicity among the NAFLD.
 Result: High total cholesterol was found in 64.4 %, High LDL was found in 20.8 %, Low HDL is present in 72.2% and high triglyceride is present in 65.8 % patients with NAFLD. Non-HDL cholesterol was significantly higher in NAFLD compared to control group (116.75 ± 34.38 vs. 137.63 ± 39.76, p=0.00). Similarly, calculated cardiac risk ratio (TC/HDL) was significant higher (4.15 ± 1.18 vs. 5.25 ± 1.78, p=0.00) whereas atherogenic index of plasma (AIP) was higher (0.30 ± 0.13 vs. 0.33 ± 0.19, p=0.37).
 Conclusion: NAFLD is significantly associated with atherogenic dyslipidemia. Calculated cardiac risk and AIP is higher in patients with NAFLD. Therefore it may be helpful to assess dyslipidemia among the patients with NAFLD to prevent cardiovascular events.

Atherogenic Index of Plasma (AIP) and Its Association with Fatty Liver in Obese Adolescents

“…Our findings demonstrate the association of all lipid levels with fatty liver and obesity. However, based on literature data [ 15 , 16 , 17 , 18 , 41 , 42 , 43 ] and our study’s findings, we think that it is more valuable to calculate AIP levels and show their relationship with fatty liver. In addition, many studies continue to show the superiority of AIP.…”

“…However, they could not find a difference between the total NAFLD group and the healthy control group in terms of AIP values. Since NAFLD is significantly associated with atherogenic dyslipidemia, they stated that AIP may be useful in evaluating dyslipidemia to prevent CVD [ 16 ]. Xie et al reported higher BMI, ALT, AST, and AIP values in NAFLD patients.…”

“…However, total cholesterol/HDL cholesterol, LDL cholesterol/HDL cholesterol, and triglyceride/HDL cholesterol rates are preferable indicators of metabolic and clinical links among lipid fractions and have better predictive powers than parameters used independently of disease conditions [ 14 ]. Researchers have examined the relationship between another lipid ratio, the atherogenic index of plasma (AIP) and NAFLD, and they found a relationship between them [ 15 , 16 , 17 , 18 , 19 , 20 ]. Studies show that AIP is a strong indicator of NAFLD and can predict CVD development [ 15 , 16 , 17 , 18 , 19 ].…”

“…Researchers have examined the relationship between another lipid ratio, the atherogenic index of plasma (AIP) and NAFLD, and they found a relationship between them [ 15 , 16 , 17 , 18 , 19 , 20 ]. Studies show that AIP is a strong indicator of NAFLD and can predict CVD development [ 15 , 16 , 17 , 18 , 19 ]. However, studies in the pediatric age group are limited.…”