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

ObjectiveCurrent 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 non-obese Chinese ind...

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Main Authors: Weitao Wu, Donghai Wu, Changchun Cao, Ronghua Zhou, Shihua Ding, Ying Ying, Dayong Sun, Haofei Hu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1618576/full
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author Weitao Wu
Weitao Wu
Donghai Wu
Donghai Wu
Changchun Cao
Ronghua Zhou
Shihua Ding
Shihua Ding
Ying Ying
Ying Ying
Dayong Sun
Dayong Sun
Haofei Hu
Haofei Hu
author_facet Weitao Wu
Weitao Wu
Donghai Wu
Donghai Wu
Changchun Cao
Ronghua Zhou
Shihua Ding
Shihua Ding
Ying Ying
Ying Ying
Dayong Sun
Dayong Sun
Haofei Hu
Haofei Hu
author_sort Weitao Wu
collection DOAJ
description ObjectiveCurrent 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 non-obese Chinese individuals with normal lipids.MethodsThis 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.ResultsThe 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 mmol2/L2, 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/m2. LCI demonstrated superior predictive value for NAFLD compared to individual lipid parameters, with an area under the ROC curve of 0.717.ConclusionThis study offers novel insights into the relationship between LCI and NAFLD risk in non-obese Chinese individuals with normal lipid levels. The non-linear association and the moderate discriminatory ability of LCI suggest its potential utility as a practical screening marker for population-level risk stratification and early preventive strategies in seemingly low-risk, normal-weight populations.
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spelling doaj-art-ac76a026ce2340cfa4f266070826fbd72025-08-20T03:36:44ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-08-011210.3389/fmed.2025.16185761618576Lipoprotein combine index is associated with non-alcoholic fatty liver disease: a 5-year longitudinal cohort study in non-obese Chinese populations with normal lipidsWeitao Wu0Weitao Wu1Donghai Wu2Donghai Wu3Changchun Cao4Ronghua Zhou5Shihua Ding6Shihua Ding7Ying Ying8Ying Ying9Dayong Sun10Dayong Sun11Haofei Hu12Haofei Hu13Department of Gastroenterology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaDepartment of Rehabilitation, Shenzhen Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, ChinaDepartment of Endoscopy, Pengpai Memorial Hospital, Shanwei, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaDepartment of Physiology, Shenzhen University Medical School, Shenzhen, Guangdong, ChinaDepartment of Gastroenterology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaShenzhen University Health Science Center, Shenzhen, Guangdong, ChinaDepartment of Nephrology, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, ChinaObjectiveCurrent 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 non-obese Chinese individuals with normal lipids.MethodsThis 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.ResultsThe 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 mmol2/L2, 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/m2. LCI demonstrated superior predictive value for NAFLD compared to individual lipid parameters, with an area under the ROC curve of 0.717.ConclusionThis study offers novel insights into the relationship between LCI and NAFLD risk in non-obese Chinese individuals with normal lipid levels. The non-linear association and the moderate discriminatory ability of LCI suggest its potential utility as a practical screening marker for population-level risk stratification and early preventive strategies in seemingly low-risk, normal-weight populations.https://www.frontiersin.org/articles/10.3389/fmed.2025.1618576/fullnon-alcoholic fatty liver diseaselipoprotein combine indexcohort studyCox proportional-hazards regressionnon-linear
spellingShingle Weitao Wu
Weitao Wu
Donghai Wu
Donghai Wu
Changchun Cao
Ronghua Zhou
Shihua Ding
Shihua Ding
Ying Ying
Ying Ying
Dayong Sun
Dayong Sun
Haofei Hu
Haofei Hu
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
Frontiers in Medicine
non-alcoholic fatty liver disease
lipoprotein combine index
cohort study
Cox proportional-hazards regression
non-linear
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic non-alcoholic fatty liver disease
lipoprotein combine index
cohort study
Cox proportional-hazards regression
non-linear
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1618576/full
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