Remnant cholesterol, a potential risk factor of metabolic dysfunction-associated fatty liver disease

Abstract

Objectives: This study aimed to explore the association between remnant cholesterol and metabolic dysfunction-associated fatty liver disease (MAFLD) in an adult population in the United States. Methods: Data were collected from the National Health and Nutrition Examination Survey database during 2017–2020. Weighted multivariable logistic regression analyses and receiver operating characteristic (ROC) curves were used to investigate the association between remnant cholesterol and the risk of MAFLD. Subgroup and interaction analyses were performed. To further investigate the possible non-linear relationship between remnant cholesterol and MAFLD, a restricted cubic spline was used. Results: Among the included 3633 participants, the prevalence rate of MAFLD was 34.56%. After full adjustment, higher remnant cholesterol was associated with the risk of MAFLD (odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01–1.06; P = 0.02), and compared with the lowest quartile of remnant cholesterol, the highest quartile of remnant cholesterol was more likely to be associated with MAFLD (OR, 3.70; 95%CI, 2.37,5.76; P < 0.0001). A non-linear relationship between remnant cholesterol and MAFLD was found in the restricted cubic spline regression model, suggesting that the risk of MAFLD initially increased rapidly and then gradually slowed down. Conclusion: Remnant cholesterol was identified as a potential risk factor for MAFLD, and a non-linear relationship between remnant cholesterol and the prevalence of MAFLD was detected. Large-scale, high-quality prospective studies are required to validate these findings.