Journal of clinical lipidologyApr 9, 2016

Severity of nonalcoholic fatty liver disease is linked to cholesterol and fat levels compared to good cholesterol

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Updated Apr 4, 2026

Abstract

The prevalence rate of fatty liver in the study was 53.76%.

Higher total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) and triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratios may be associated with an increased risk of nonalcoholic fatty liver disease (NAFLD).
Individuals in the subgroup with the lowest lipid ratios showed a lower prevalence of NAFLD, hypertension, and diabetes compared to those with higher ratios.
Patients with elevated lipid ratios could have a significantly greater risk for advanced forms of NAFLD.

Simplified

BACKGROUND: Limited data support the notion that lipid ratios are risk factors for nonalcoholic fatty liver disease (NAFLD). We evaluated the association between lipid ratios and NAFLD.

METHODS: This was a large population, cross-sectional, retrospective study. Data on NAFLD severity, blood pressure, fasting glucose, total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDL-C) levels were obtained from 44,767 examinees at single health checkup center. The enrollees were stratified into four subgroups based on their TC/HDL-C and TG/HDL-C ratios. We used multivariate analyses to evaluate the odds between lipid ratios and NAFLD.

RESULTS: The prevalence rate of fatty liver in this study was 53.76%. In the baseline subgroup with the lowest TC/HDL-C and TG/HDL-C ratios, the prevalence of NAFLD, hypertension, and diabetes was lower than that of the other three subgroups. Patients with higher lipid ratios had a significantly greater risk for advanced NAFLD.

CONCLUSIONS: Adults with high TC/HDL-C or TG/HDL-C ratios, or both, have a greater risk for NAFLD, especially advanced NAFLD.

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Severity of nonalcoholic fatty liver disease is linked to cholesterol and fat levels compared to good cholesterol

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