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.
