Lipoprotein and metabolic profiles indicate similar cardiovascular risk of liver steatosis and NASH

Question Non-alcoholic fatty liver disease (NAFLD) affects about 25 % of the global population, with no reliable non-invasive tests to diagnose non-alcoholic steatohepatitis (NASH) and to differ between NASH and NAFL (steatosis alone). It is unclear if NAFL and NASH differ in cardiovascular risk for patients. Here, we compared obese NAFLD patients with a healthy cohort, to test, whether cholesterol compounds could represent potential non-invasive markers and to estimate associated risks.

Methods Serum samples of 46 patients with histologically confirmed NAFLD (17 NAFL, 29 NASH) that underwent bariatric surgery were compared to 32 (9 males, 21 female) healthy controls (HC). We analyzed epidemiological data, liver enzymes, cholesterol-, lipid- profile and amino acids. The latter were analyzed by nuclear magnetic resonance (NMR) spectroscopy.

Results Total serum - and HDL- cholesterol were significantly lower in NAFLD groups than in HC with a stronger reduction in NASH. Similar observations were made for sub specification of HDL-p, HDL-s, SHDL-p, and LHDL-p cholesterols. LDL-s and LLDL-p cholesterol were significantly reduced in NAFLD groups. Interestingly, SLDL-p cholesterol was significantly higher in NAFL with a stronger elevation in NASH compared to HC. The amino acids alanine, leucin, and isoleucine were significantly higher in NAFL and NASH compared to HC.

Conclusions We show in this study that cholesterol profiles, apolipoproteins and amino acids could function as a potential non-invasive test to screen for NAFLD or even NASH in larger populations. However, few differences in cholesterol profiles were identified between NAFL and NASH, indicating similar cardiovascular risk profiles.

Publication History

Article published online:
04 January 2021