Triglyceride-Rich Lipoproteins and Glycoprotein A and B Assessed by 1H-NMR in Metabolic-Associated Fatty Liver Disease

High plasma triglyceride (TG) levels and chronic inflammation are important factors related to metabolic-associated fatty liver disease in patients at cardiovascular risk. Using nuclear magnetic resonance (H-1-NMR), we aimed to study the triglyceride-rich lipoprotein (TRL) and acute-phase glycoprotein profiles of a cohort of patients with metabolic disease and their relationship with fatty liver. Plasma samples of 280 patients (type 2 diabetes, 81.1%; obesity, 63.3%; and metabolic syndrome, 91.8%) from the University Hospital Lipid Unit were collected for the measurement of small, medium and large TRL particle numbers and sizes and glycoprotein profiles (Glyc-A and Glyc-B) by H-1-NMR. Liver function parameters, including the fatty liver index (FLI) and fibrosis-4 (FIB-4) score, were assessed. Hepatic echography assessment was performed in 100 patients, and they were followed up for 10 years. TRL particle concentrations showed a strong positive association with Glyc-A and Glyc-B (rho=0.895 and rho=0.654, p<0.001, respectively) and with the liver function-related proteins ALT rho=0.293, p<0.001), AST (rho=0.318, p<0.001) and GGT (rho=0.284, p<0.001). Likewise, TRL concentrations showed a positive association with FLI (rho=0.425, p<0.001) but not with FIB-4. During the follow-up period of 10 years, 18 new cases of steatosis were observed among 64 patients who were disease-free at baseline. Baseline TRL particle numbers and glycoprotein levels were associated with the new development of metabolic-associated fatty liver disease (MAFLD) (AUC=0.692, p=0.018 and AUC=0.669, p=0.037, respectively). Overall, our results indicated that TRL number and acute-phase glycoproteins measured by H-1-NMR could be potential biomarkers of the development of hepatic steatosis in patients at metabolic risk.

Automated summary

This study used nuclear magnetic resonance (NMR) to investigate the relationship between triglyceride-rich lipoproteins and acute-phase glycoprotein profiles with fatty liver in patients with metabolic diseases. The study found a strong positive correlation between triglyceride-rich lipoprotein concentrations and acute-phase glycoproteins, as well as liver function-related proteins. The results also showed that baseline triglyceride-rich lipoprotein numbers and glycoprotein levels were associated with the development of metabolic-associated fatty liver disease during a 10-year follow-up period.