Cholesterol efflux capacity is impaired in subjects with an elevated Fatty Liver Index, a proxy of non-alcoholic fatty liver disease. (October 2018)

• Record Type: Journal Article
• Authors: van den Berg, Eline H.; Gruppen, Eke G.; Ebtehaj, Sanam; Bakker, Stephan J.L.; Tietge, Uwe J.F.; Dullaart, Robin P.F.
• Is Part Of: Atherosclerosis. Volume 277(2018)
• Page Start: 21
• Page End: 27
• Publication Date: 2018-10
• Subjects: Cholesterol efflux capacity -- Fatty Liver Index -- HDL cholesterol -- hsCRP -- Metabolic syndrome -- Non-alcoholic fatty liver disease -- Type 2 diabetes mellitus; ApoA-I apolipoprotein A-I -- apoB apolipoprotein B -- ALT alanine aminotransferase -- AST aspartate aminotransferase -- ATP-binding cassette transporter ABC)A1 -- BMI body mass index -- CVD cardiovascular disease -- CEC cholesterol efflux capacity -- dpm disintegrations per minute -- hsCRP high sensitivity C-reactive protein -- eGFR estimated glomerular filtration rate -- FLI Fatty Liver Index -- GGT gamma-glutamyltransferase -- HDL high density lipoproteins -- LDL low density lipoproteins -- MetS metabolic syndrome -- NAFLD non-alcoholic fatty liver disease -- NASH non-alcoholic steatohepatitis -- NAFLD non-alcoholic fatty liver disease -- NCEP-ATP III National Cholesterol Education Program Adult Treatment Panel III -- PBS phosphate buffered saline -- PREVEND prevention of renal and vascular end-stage Disease -- RPMI Roswell Park Memorial Institute -- SR-BI scavenger receptor class B type 1 -- T2D type 2 diabetes mellitus -- UAE urinary albumin excretion; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2018.07.028
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Non-alcoholic fatty liver disease (NAFLD) parallels the obesity epidemic and associates with components of the metabolic syndrome (MetS). Cholesterol efflux capacity (CEC) represents a key metric of high density lipoprotein (HDL) function which may predict atherosclerotic cardiovascular disease (CVD). Here we assessed the relationship of CEC with NAFLD. Methods: CEC was determined from THP-1 macrophage foam cells towards apolipoprotein B-depleted plasma among 639 subjects (454 men; 36 subjects with type 2 diabetes mellitus (T2D); 226 with MetS), participating in the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study. A Fatty Liver Index (FLI) ≥ 60 was used as a proxy of NAFLD. Results: 372 participants had a FLI ≥60, which coincided with an increased prevalence of T2D and MetS ( p = 0.009 and p < 0.001), as well as with central obesity, higher systolic blood pressure, glucose, total cholesterol, triglycerides and high sensitivity C-reactive protein (hsCRP), and decreased HDL cholesterol ( p < 0.001 for each). In multivariable linear regression analyses, CEC was inversely associated with an elevated FLI, when taking account of clinical covariates (fully adjusted model: β = −0.091, p = 0.043), and alternatively when taking account of systolic blood pressure, waist/hip ratio, glucose, HDL cholesterol, triglycerides and hsCRP (fully adjusted model: β = −0.103, p = 0.034). Conclusions: Impaired CEC is associated with NAFLD, as inferred from a FLI≥60, even when taking account of lower HDL cholesterol and enhanced low-grade chronic inflammation. Reduced CEC could contribute to accelerated CVD in NAFLD patients. Highlights: NAFLD is associated with elevations in apoB lipoproteins and low HDL-C. Cholesterol efflux capacity (CEC) was measured in 639 subjects with suspected NAFLD. CEC was impaired in subjects with suspected NAFLD, i.e. a Fatty Liver Index (FLI) ≥60. CEC remained inversely associated with an elevated FLI independent of HDL-C. NAFLD may contribute to impaired HDL function, even when taking account of HDL-C.