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Abstract：
Associations between dyslipidemia and metabolic dysfunction-associated steatotic liver disease (MASLD) have been reported. Previous studies have shown that the triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio may be a surrogate marker of MASLD, assessed by liver ultrasound. However, no studies have evaluated the utility of this ratio according to biopsy-proven MASLD and its stages. Therefore, our aim was to evaluate if the TG/HDL-C ratio allows for the identification of biopsy-proven MASLD in patients with obesity. We conducted a case-control study in 153 patients with obesity who underwent metabolic surgery and had a concomitant liver biopsy. Fifty-three patients were classified as no MASLD, 45 patients as metabolic dysfunction-associated steatotic liver-MASL, and 55 patients as metabolic dysfunction-associated steatohepatitis-MASH. A receiver operating characteristic (ROC) analysis was performed to assess the accuracy of the TG/HDL-C ratio to detect MASLD. We also compared the area under the curve (AUC) of the TG/HDL-C ratio, serum TG, and HDL-C. A higher TG/HDL-C ratio was observed among patients with MASLD, compared with patients without MASLD. No differences in the TG/HDL-C ratio were found between participants with MASL and MASH. The greatest AUC was observed for the TG/HDL-C ratio (AUC 0.747, p < 0.001) with a cut-off point of 3.7 for detecting MASLD (sensitivity = 70%; specificity = 74.5%). However, no statistically significant differences between the AUC of the TG/HDL-C ratio and TG or HDL-C were observed to detect MASLD. In conclusion, although an elevated TG/HDL-C ratio can be found in patients with MASLD, this marker did not improve the detection of MASLD in our study population, compared with either serum TG or HDL-C.
摘要：
已经报道了血脂异常与代谢功能障碍相关的脂肪变性肝病（MASLD）之间的关联。先前的研究表明，甘油三酯与高密度脂蛋白胆固醇（TG/HDL-C）的比值可能是MASLD的替代指标，通过肝脏超声评估。然而,没有研究根据活检证实的MASLD及其分期评估该比值的实用性.因此,我们的目的是评估TG/HDL-C比值是否可以鉴别肥胖患者的活检证实的MASLD.我们在153例肥胖患者中进行了一项病例对照研究，这些患者接受了代谢手术并同时进行了肝活检。53名患者被归类为无MASLD，45例患者为代谢功能障碍相关脂肪变性肝脏-MASL，55例患者为代谢功能障碍相关脂肪性肝炎-MASH。进行接收器工作特性（ROC）分析以评估TG/HDL-C比率检测MASLD的准确性。我们还比较了TG/HDL-C比率的曲线下面积（AUC），血清TG,和HDL-C在MASLD患者中观察到较高的TG/HDL-C比率，与没有MASLD的患者相比。MASL和MASH患者的TG/HDL-C比值无差异。对于TG/HDL-C比率观察到最大的AUC(AUC0.747,p<0.001),检测MASLD的临界点为3.7(灵敏度=70%;特异性=74.5%)。然而,在检测MASLD时,TG/HDL-C比值的AUC与TG或HDL-C之间无统计学差异.总之,尽管在MASLD患者中可以发现TG/HDL-C比值升高，该标记没有改善我们研究人群中MASLD的检测，与血清TG或HDL-C比较
