Association between non-high-density lipoprotein cholesterol and non-alcoholic fatty liver disease among people living with HIV on dolutegravir-based antiretroviral therapy: A cross-sectional study in Southwestern Uganda

Abstract

Objective: Non-high-density lipoprotein cholesterol, an aggregate marker of atherogenic lipoproteins, has been implicated in metabolic dysfunction and may predict non-alcoholic fatty liver disease risk. Our study investigated the association between non-high-density lipoprotein cholesterol and non-alcoholic fatty liver disease among people living with Human Immunodeficiency Virus on dolutegravir-based antiretroviral therapy in southwestern Uganda. We conducted a secondary analysis of data obtained from a cross-sectional study of 377 adults who had been on dolutegravir-based antiretroviral therapy for ≥12 months at Ruhoko Health Centre IV, southwestern Uganda. Results: Of the 377 participants, 42(11.1%; 95CI: 8.3–14.8) had non-alcoholic fatty liver disease. We observed a significant association between high non-high-density lipoprotein cholesterol and non-alcoholic fatty liver disease; second tertile (aOR=3.08, 95% CI: 1.06–8.99, p=0.039) and third tertile (aOR=4.46, 95% CI: 1.25–15.88, p=0.021). At an optimal cut-off of ≥113.4 with a sensitivity of 69% and specificity of 48%, non-high-density lipoprotein cholesterol had a significant discriminative ability; AUC=0.654(95%CI:0.561–0.747) to distinguish participants with from those without non-alcoholic fatty liver disease. Therefore, High non-high-density lipoprotein cholesterol is a potential predictor for non-alcoholic fatty liver disease.