Highlights
- •The association between Lp(a) and fatty liver disease (FLD) remains controversial.
- •Serum Lp(a) levels were inversely associated with the presence of FLD.
- •Subjects with low Lp(a) and high insulin resistance (IR) showed an increased risk of FLD.
Abstract
Background and aims
High lipoprotein(a) [Lp(a)] levels are associated with increased risk of cardiovascular
disease. However, the association between Lp(a) and fatty liver disease (FLD) remains
controversial. Therefore, we analyzed the relationship between FLD and serum Lp(a)
levels in Korean adults.
Methods
A total of 22,534 participants who underwent a routine health screening program at
Kangbuk Samsung Hospital in 2010 and 2014 were enrolled. Anthropometric and biochemical
parameters, including Lp(a), were measured. The presence of FLD was assessed using
abdominal ultrasonography. Odds ratios (ORs) for the presence of FLD were analyzed
in quartile groups of serum Lp(a) levels using logistic regression. We divided the
participants into four groups according to the median values of Lp(a) and homeostasis
model assessment for insulin resistance (HOMA-IR).
Results
Among the total study population, 3030 (13.4%) participants had fatty liver disease.
The mean Lp(a) level was lower in subjects with FLD than in those without (70.0 vs 73.8 nmol/L, p < 0.001). The OR for FLD was the lowest in the fourth Lp(a) quartile group, using
the first quartile group as the reference group after adjusting for confounding factors
[0.815; 95% confidence interval (CI) 0.725–0.916]. When the OR for FLD was analyzed
in four groups divided by the median values of Lp(a) and HOMA-IR, the low Lp(a)-high
HOMA-IR group had the greatest OR for FLD, using the high Lp(a)-low HOMA-IR group
as the reference (1.903; 95% CI 1.679–2.158).
Conclusions
Serum Lp(a) levels were inversely associated with the presence of FLD. Subjects with
low Lp(a) and high insulin resistance (IR) showed higher risk of FLD than those with
high Lp(a) and low IR, suggesting the opposite associations of Lp(a) and IR with FLD.
Graphical abstract
Graphical Abstract
Keywords
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Article Info
Publication History
Published online: July 29, 2020
Accepted:
July 17,
2020
Received in revised form:
July 10,
2020
Received:
December 17,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
