The newly proposed plasma-glycosylated hemoglobin A1c/High-Density lipoprotein cholesterol ratio serves as a simple and practical indicator for screening metabolic associated fatty liver disease: an observational study based on a physical examination population

• Published in: BMC gastroenterology 2024-08, Vol.24 (1), p.274-10, Article 274
• Main Authors: He, Shiming, Lu, Song, Yu, Changhui, Kuang, Maobin, Qiu, Jiajun, Sheng, Guotai, Zou, Yang
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biomarkers - blood; Blood; Body mass index; Cholesterol; Cholesterol, HDL; Cholesterol, HDL - blood; Chronic illnesses; Complications and side effects; Datasets; Diabetes; Diagnosis; Exercise; Fatty liver; Female; Gender; Glucose; Glycated Hemoglobin - analysis; Glycated Hemoglobin - metabolism; Glycosylated hemoglobin; HbA1c/HDL-C ratio; Health aspects; Hemoglobin; High density lipoprotein; Hospitals; Humans; Lipids; Liver diseases; Logistic Models; MAFLD; Male; Mass Screening - methods; Measurement; Medical examination; Metabolic associated fatty liver disease; Metabolic diseases; Metabolism; Middle Aged; Non-alcoholic Fatty Liver Disease - blood; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Obesity; Physical Examination; Physical fitness; Plasma-glycosylated hemoglobin A1c/High-Density lipoprotein cholesterol ratio; Population density; Population studies; Practical indicator; Risk Factors; ROC Curve; Womens health
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-024-03362-0

Glycotoxicity and lipotoxicity are key pathophysiological mechanisms underlying the development of metabolic associated fatty liver disease (MAFLD). The primary objective of this study is to investigate the association between the newly proposed Plasma-Glycosylated Hemoglobin A1c/High-Density Lipoprotein Cholesterol Ratio (HbA1c/HDL-C ratio) and the risk of MAFLD. A study population of 14,251 individuals undergoing health examinations was included. The association between the HbA1c/HDL-C ratio and MAFLD was analyzed using multivariable logistic regression and restricted cubic spline (RCS) analysis. Exploratory analyses were conducted to assess variations in this association across subgroups stratified by gender, age, body mass index (BMI), exercise habits, drinking status, and smoking status. The discriminatory value of the HbA1c/HDL-C ratio and its components for screening MAFLD was evaluated using receiver operating characteristic (ROC) curves. A total of 1,982 (13.91%) subjects were diagnosed with MAFLD. After adjusting for confounding factors, we found a significant positive association between the HbA1c/HDL-C ratio and MAFLD [odds ratio (OR) 1.34, 95% confidence interval (CI): 1.25, 1.44]. No significant differences in this association were observed across all subgroups (All P for interaction > 0.05). Furthermore, through RCS analysis, we observed a nonlinear positive correlation between the HbA1c/HDL-C ratio and MAFLD (P for non-linearity