Korean J Fam Pract 2020; 10(2): 110-115  https://doi.org/10.21215/kjfp.2020.10.2.110
The Association between Non-Alcoholic Fatty Liver Disease Fibrosis Score and Serum Low Density Lipoprotein-Cholesterol Levels in Adults with Non-Alcoholic Fatty Liver Disease
Sang Bong Park, Hee Jeong Choi*, Song Hee Doo, Dong Jung, Ye Na Shim, Han Jin Oh
Department of Family Medicine, Eulji University Hospital, Daejeon, Korea
Hee Jeong Choi
Tel: +82-42-611-3231, Fax: +82-42-611-3776
E-mail: ohinia@daum.net
ORCID: http://orcid.org/0000-0001-6085-5770
Received: September 3, 2019; Revised: January 22, 2020; Accepted: January 29, 2020; Published online: April 20, 2020.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Non-alcoholic fatty liver disease fibrosis score (NFS) is a scoring system applied in clinical practice to predict advanced fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). Evidence shows that progression of steatohepatitis and liver fibrosis reduces the production of very-low-density lipoprotein. The aim of this study was to identify the association of NFS and serum low-density lipoprotein cholesterol (LDL-C) levels and in adults with NAFLD.
Methods: Data were gathered from 24,889 subjects who had visited a health promotion center. NFS was calculated to assess the severity of fibrosis in all the subjects. Serum LDL-C levels were measured using a direct method.
Results: Serum LDL-C levels tended to decrease with increasing NFS quartiles (P for trend<0.01). NFS was one of the major determinants of serum LDL-C level after adjusting for age, sex, lifestyle-related factors, and other covariates. The estimated mean serum LDL-C level was significantly lower in the highest quartile of NFS than in the lowest quartile of NFS.
Conclusion: NFS had a negative association with serum LDL-C levels in adults with NAFLD. Elevated LDL-C level is not only a risk factor of cardiovascular disease but also a predictive indicator of NAFLD severity.
Keywords: Nonalcoholic Fatty Liver Disease; Cholesterol, LDL; Cholesterol, VLDL; Fibrosis
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