The fasting plasma glucose to high-density lipoprotein cholesterol ratio: a novel index for identifying NAFLD

Previous research has indicated that the fasting plasma glucose to high-density lipoprotein cholesterol ratio (FHR) is a novel biomarker for assessing cardiovascular disease prognosis. The objective of this study is to investigate the potential relationship of FHR with non-alcoholic fatty liver disease (NAFLD).

The present study employed a retrospective design and included 14,251 participants who underwent health examinations. Restricted cubic spline regression and multivariable logistic regression were used to assess the relationship of NAFLD with FHR. The performance of the FHR in identifying NAFLD was analyzed through receiver operating curve analysis.

After adjustment for confounders, a positive association of FHR with NAFLD was observed in the multivariable logistic regression model. Compared to the lowest FHR quartile, the odds ratios for the 2, 3, and 4 quartiles were 1.49 (1.14, 1.94), 2.03 (1.57, 2.63), and 2.34 (1.79, 3.06), respectively. Additionally, restricted cubic spline regression analysis revealed a nonlinear relationship of FHR with NAFLD prevalence with a potential threshold effect. The prevalence of NAFLD remained nearly unchanged when the FHR was less than 3, but increased progressively when the ratio exceeded 3. Further receiver operating curve analysis demonstrated that the FHR significantly outperformed fasting plasma glucose or high-density lipoprotein cholesterol alone in identifying NAFLD, with an optimal threshold identified at 3.89.

The FHR is a new index used to identify NAFLD, and the incorporation of the FHR into the risk stratification assessment system for NAFLD may be of significant help.