Scientific reportsJan 3, 2025

Higher GGT to HDL ratio linked to increased risk of fatty liver disease and liver scarring

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Apr 4, 2026

Abstract

In a sample of 4764 individuals, an elevated gamma-glutamyl transferase to high-density lipoprotein cholesterol (/) ratio is associated with an increased risk of non-alcoholic fatty liver disease ().

There is a non-linear association between GGT/HDL-C levels and the risk of NAFLD.
Higher GGT/HDL-C ratios are strongly related to the risk of liver fibrosis and the degree of liver fat accumulation.
Subgroup analyses indicate a significant correlation between the GGT/HDL-C ratio and NAFLD risk among Mexican Americans and individuals aged 20-40.
GGT/HDL-C is a more accurate predictor of NAFLD compared to GGT or HDL-C alone.
Increased GGT/HDL-C ratios are independently correlated with the severity of liver fat and the risk of liver fibrosis in the U.S. population.

Simplified

This study investigated the association between and liver fibrosis and the ratio of gamma-glutamyl transferase to high-density lipoprotein cholesterol (/). In this cross-sectional study, we included 4764 subjects who participated in the National Health and Nutrition Examination Survey (NHANES) during 2017-2018. Adjusted multivariate logistic regression analysis was utilized to evaluate the relationships between GGT/HDL-C levels and NAFLD, fatty liver degree, and liver fibrosis. The non-linear link between NAFLD and the GGT/HDL-C ratio was examined using generalized additive models. There was a non-linear association between GGT/HDL-C and the risk of NAFLD, and all regression models demonstrated a strong relationship between GGT/HDL-C levels and the risk of liver fibrosis, the degree of hepatic steatosis, and the prevalence of NAFLD. Subgroup analyses revealed a significant correlation between the risk of NAFLD and the GGT/HDL-C ratio among Mexican Americans and young people in the 20-40 age range. The receiver operating characteristic (ROC) study showed that GGT/HDL-C was a more accurate predictor of NAFLD than GGT or HDL-C alone. In the U.S. population, an increased risk of NAFLD, the severity of hepatic steatosis, and the risk of liver fibrosis are independently correlated with an elevated GGT/HDL-C ratio.

Key numbers

1.741×

Increased Risk

Odds ratio for risk per unit increase in /

0.741

ROC AUC for Prediction

Area under the curve in ROC analysis for /

4764

Study Population Size

Total number of participants in the NHANES study

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Funding

Competing interests

Declarations. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: The National Center for Health Statistics ethics review board approved all NHANES protocols. The participants provided written informed consent to participate in this study. This study uses publicly available secondary data.

PubMed

Higher GGT to HDL ratio linked to increased risk of fatty liver disease and liver scarring

Abstract

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Funding

Competing interests

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Abstract

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