ORIGINAL RESEARCH article
Front. Med.
Sec. Hepatobiliary Diseases
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1618576
This article is part of the Research TopicHot Topics in Diabetes and Steatotic Liver DiseaseView all 12 articles
Lipoprotein combine index is associated with non-alcoholic fatty liver disease: a 5-year longitudinal cohort study in non-obese Chinese populations with normal lipids
Provisionally accepted
- 1Department of Gastroenterology, The First Affiliated Hospital of Shenzhen University, The Second People's Hospital of Shenzhen, Shenzhen, China
- 2Dapeng New District Nan’ao People’s Hospital, Shenzhen, China
- 3Pengpai Memorial Hospital, Shanwei, China
- 4School of Medicine, Shenzhen University, Shenzhen, Guangdong Province, China
- 5Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, China
- 6the first affiliated hospital of Shenzhen University, Shenzhen, China
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Objective: Current evidence concerning the association between lipoprotein combine index (LCI) and Non-alcoholic fatty liver disease (NAFLD) in non-obese people remains limited. This 5-year longitudinal cohort study aimed to explore the connection between LCI and risk of NAFLD in nonobese Chinese individuals with normal lipids.Methods: This retrospective cohort study from January 2010 to December 2014 consecutively and non-selectively collected 9,838 non-obese participants with normal lipid profiles in a Chinese hospital. Using the Cox proportional-hazards regression model, we explored the relationship between baseline LCI and NAFLD risk. We applied cubic spline functions and curve fitting to characterize the non-linear association between LCI and NAFLD. Simultaneously, we conducted sensitivity and subgroup analyses, and employed receiver operating characteristic (ROC) curve analysis to evaluate the predictive potential of LCI for NAFLD incidence.The mean age of participants was 42.46 ± 14.70 years, with males comprising 51.40% of the cohort. During a median follow-up period of 33.10 months, 855 participants (8.89%) progressed NAFLD, with an incidence of 31.51 cases per 1,000 person-years. A significant non-linear relationship was identified between LCI and NAFLD risk with an inflection point at 5.514 mmol 2 /L 2 , where the HR was significantly stronger below this threshold (HR=1.282, 95%CI: 1.162-1.415) compared to above it (HR=1.063, 95%CI: 1.042-1.084). Subgroup analysis revealed the strongest associations in participants with body mass index (BMI) between 18.5 and 24 kg/m 2 . LCI demonstrated superior predictive value for NAFLD compared to individual lipid parameters, with an area under the ROC curve of 0.717.This study offers novel insights into the relationship between LCI and NAFLD risk in
Keywords: Non-alcoholic fatty liver disease, Lipoprotein combine index, cohort study, Cox proportional-hazards regression, non-linear
Received: 26 Apr 2025; Accepted: 04 Aug 2025.
Copyright: © 2025 Wu, Wu, Cao, Zhou, Ding, Ying, Sun and Hu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haofei Hu, Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, China
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