Nonalcoholic fatty liver disease and serum lipoproteins: The Multi-Ethnic Study of Atherosclerosis

Andrew Paul DeFilippis, Michael J. Blaha, Seth S. Martin, Robert M. Reed, Steven R. Jones, Khurram Nasir, Roger S. Blumenthal, Matthew J. Budoff

Research output: Contribution to journalArticlepeer-review

151 Scopus citations


Objective: While nonalcoholic fatty liver disease (NAFLD) is associated with the metabolic syndrome, it is not known if NAFLD plays an independent role in the atherogenic dyslipidemia phenotype. Methods and results: The Multi-Ethnic Study of Atherosclerosis (MESA) is a population-based prospective cohort study of adults free of clinical cardiovascular disease at enrollment. We tested for a relationship between NAFLD, defined as a liver/spleen (L/S) attenuation ratio of <1 on a non-contrast cardiac CT scan, and multiple measures of fasting serum lipoprotein size, cholesterol and particle concentrations.NAFLD was present in 569 (17%) of 3362 participants. After adjustment for multiple metabolic risk factors, adiposity and measures of insulin resistance (HOMA-IR), NAFLD was independently associated with higher fasting serum triglycerides and lower serum HDL-C. Despite a lack of association with LDL-C, NAFLD was associated with higher LDL particle concentration and lower LDL particle size. Modeling the L/S ratio as a continuous variable, a severity dependent association was observed between atherogenic lipoprotein abnormalities and NAFLD. Conclusion: In a large, multi-ethnic, gender balanced cohort, CT-diagnosed NAFLD was associated with the atherogenic dyslipidemia phenotype in a dose dependent fashion. These relationships persisted after adjustment for several metabolic risk factors and HOMA-IR, suggesting a possible independent pathophysiologic role between NAFLD and dyslipidemia.

Original languageEnglish (US)
Pages (from-to)429-436
Number of pages8
Issue number2
StatePublished - Apr 2013


  • Cardiac CT scan
  • Lipoproteins
  • MESA
  • NMR
  • Nonalcoholic fatty liver disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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