Lipid Indices for Diagnosing Non-alcoholic Fatty Liver in China

Background: Non-alcoholic fatty liver disease (NAFLD) represents a significant global health burden, particularly in China where there is a rising incidence. Early detection is critical for effective management and prevention of related complications. Existing diagnostic tools are often not adequately sensitive or specific, leading to unmet needs in clinical practice.

Method: This study employs a multicenter cross-sectional study design involving 1,200 Chinese adults aged 30-70 years, with inclusion criteria of no history of significant alcohol consumption or viral hepatitis. The primary endpoint is the diagnostic performance of various lipid indices for NAFLD as confirmed by liver biopsy. Statistical analyses include receiver operating characteristic (ROC) curve evaluations.

Results: The study identifies three lipid indices with high diagnostic values: a total cholesterol to HDL cholesterol ratio (TC/HDL-C) with an area under the ROC curve of 0.85 (95% CI 0.82-0.88), a triglyceride to HDL ratio (TG/HDL-C) showing 78% sensitivity and 82% specificity, and an LDL cholesterol to HDL cholesterol ratio (LDL-C/HDL-C) with a risk difference of 30% for NAFLD diagnosis. These indices significantly outperform traditional diagnostic methods.

Conclusion: The identified lipid indices offer a promising approach to improve NAFLD diagnosis in the Chinese adult population, supporting their integration into routine health diagnostics. However, validation in larger and diverse cohorts is essential to address limitations such as the exclusion of individuals with alcohol consumption and small sample size.

Original citation address: https://www.besjournal.com/en/article/doi/10.3967/bes2025.161