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Study links low fasting triglyceride levels with high indicators of liver fibrosis

Low fasting triglyceride levels were associated with multiple high indices for advanced liver fibrosis, according to study data.

“We provide clinical evidence that supports an inverse linkage between triglyceride levels and liver fibrosis in the U.S. adult population,” the researchers wrote.

Researchers conducted a cross-sectional analysis using data of 11,947 adults from the National Health and Nutrition Examination Survey from 1999 to 2010. The goal was to analyze any relationship between fasting triglyceride levels and non-invasive indicators for liver fibrosis, including Fibrosis 4 Score (FIB4), Nonalcoholic Fatty Liver Disease Fibrosis Score (NFS), Ast-Platelet Ratio Index (APRI), aspartate transaminase/alanine transaminase (AST/ALT) ratio and BARD scoring system.

“To examine the similarity among these indices, we calculated Pearson correlations appropriately accounting for the sampling weights using a previously published algorithm,” the researchers wrote.

The researchers found that low fasting triglyceride levels were associated with all the elevated liver fibrosis indicators, but not APRI score. Individuals in the lowest quintile of triglycerides had an adjusted odds ratio of 3 (95% CI, 1.7-5.2) by FIB4 score and OR of 1.8 (95% Cl, 1.2-2.7) estimated by NFS, compared with patients in the highest quintile. This association remained significant when restricted to those with abnormal low-fasting triglyceride levels from “suspected NAFLD”, according to the researchers.

The inverse relationship was more obvious among men compared with women (P < .001) and Caucasians compared with African Americans or Hispanics (P < .008), but not modified by age or BMI.

In addition, fasting triglycerides had a stronger association with liver fibrosis indicators compared with albumin or total bilirubin, according to multivariate regression analysis. Albumin showed a U-shaped association with the fibrosis indicators (P quadratic < .0001). Fasting triglyceride association with fibrosis was stronger compared with total bilirubin (P = .04).

“Our study demonstrates an association between lower fasting [triglyceride] levels and higher surrogate indices of liver fibrosis,” the researchers concluded. “This suggests that sequential measurements of lipid levels, which are already commonplace in clinical practice, may assist in the routine management of chronic liver disease, especially NAFLD.” – by Melinda Stevens

Disclosures: The researchers report no relevant financial disclosures.