Excess Triglycerides in Very Low-Density Lipoprotein (VLDL) Estimated from VLDL-Cholesterol could be a Useful Biomarker of Metabolic Dysfunction Associated Steatotic Liver Disease in Patients with Type 2 Diabetes.

IF 3 2区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Tsutomu Hirano
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Abstract

Aims: We report that small dense low-density lipoprotein cholesterol (sdLDL-C) levels are sensitive biomarkers of metabolic dysfunction-associated steatotic liver disease (MASLD). Since triglyceride (TG)-rich very low-density lipoprotein (VLDL) is a precursor of sdLDL and is overproduced by MASLD, the composition of VLDL may be more directly associated with MAFLD than sdLDL-C or plasma TG. To identify TG-rich VLDL, this author proposed "Excess TG" and examined its association with MASLD.

Methods: Patients with type 2 diabetes (n=1295), excluding fasting hypertriglyceridemia (TG ≥ 400 mg/dL) and heavy drinkers were examined. Liver steatosis and visceral fat area (VFA) were evaluated using CT. VLDL-C was calculated as the total C minus direct LDL-C minus HDL-C. The average VLDL-TG level can be estimated using VLDL-C×5, according to the principle of the Friedewald equation for LDL-C. Thus, VLDL-TG was estimated as VLDL-C×5, and Excess TG was calculated as plasma TG minus VLDL-C×5.

Results: Patients with MASLD were younger, more likely to be men and drinkers, and had higher VFA, TG, sdLDL-C, and excess TG, while VLDL-C was comparable. Excess TG was found to be the most sensitive lipid parameter for identifying MASLD, independent of sdLDL-C, TG, TG/VLDL-C, and VFA. The odds ratios for MASLD were 2.4-, 3.7-, and 3.9-fold higher for Excess TG ranges of 0-24, 25-49, and ≥ 50 mg/dL, respectively, relative to <0 mg, and a close relationship remained significant after adjustment for lipid- and adiposity-related parameters.

Conclusions: Excess TG in VLDL was strongly associated with MASLD beyond TG and sdLDL-C levels, which may reflect the presence of TG-rich VLDL.

从 VLDL 胆固醇估算出的极低密度脂蛋白 (VLDL) 中过量的甘油三酯可能是 2 型糖尿病患者代谢功能障碍相关性脂肪性肝病的有用生物标志物。
目的:我们报告说,小密度低密度脂蛋白胆固醇(sdLDL-C)水平是代谢功能障碍相关性脂肪性肝病(MASLD)的敏感生物标志物。由于富含甘油三酯(TG)的极低密度脂蛋白(VLDL)是sdLDL的前体,并且会在MASLD中过度产生,因此VLDL的组成可能比sdLDL-C或血浆TG更直接地与MAFLD相关。为了确定富含 TG 的 VLDL,作者提出了 "过量 TG",并研究了其与 MASLD 的关系:方法:研究对象为 2 型糖尿病患者(n=1295),不包括空腹高甘油三酯血症(TG ≥ 400 mg/dL)和酗酒者。使用 CT 评估肝脏脂肪变性和内脏脂肪面积(VFA)。VLDL-C 的计算方法是总 C 减去直接 LDL-C 再减去 HDL-C。根据弗里德瓦尔德低密度脂蛋白胆固醇方程的原理,VLDL-C×5 可以估算出 VLDL-TG 的平均水平。因此,VLDL-TG 的估算值为 VLDL-C×5,而过量 TG 的计算值为血浆 TG 减去 VLDL-C×5:结果:MASLD 患者更年轻,更可能是男性和饮酒者,其 VFA、TG、sdLDL-C 和过量 TG 均较高,而 VLDL-C 与之相当。研究发现,过量 TG 是识别 MASLD 最敏感的血脂参数,与 sdLDL-C、TG、TG/VLDL-C 和 VFA 无关。相对于<0 mg,过量总胆固醇范围为 0-24、25-49 和≥50 mg/dL 时,MASLD 的几率分别是 0-24、25-49 和≥50 mg/dL 的 2.4 倍、3.7 倍和 3.9 倍,在调整血脂和脂肪相关参数后,这种密切关系仍然显著:结论:VLDL中过量的TG与MASLD密切相关,超出了TG和sdLDL-C水平,这可能反映了富含TG的VLDL的存在。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.60
自引率
15.90%
发文量
271
审稿时长
1 months
期刊介绍: JAT publishes articles focused on all aspects of research on atherosclerosis, vascular biology, thrombosis, lipid and metabolism.
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