Association of Anti-oxidative Capacity of HDL With Subclinical Atherosclerosis in Non-alcoholic Fatty Liver Disease

Background: Non-alcoholic fatty liver disease (NAFLD) patients are at the substantial risk for the for developing cardiovascular disease (CVD). High-density lipoprotein (HDL) is well known to have protective effects against the development of atherosclerotic CVD. One of the major antiatherogenic effect of HDL is its anti-oxidative function. Objectives: This study investigated the association of anti-oxidative function of HDL with NAFLD and CVD risk. Methods: A total of 143 subjects including 51 NAFLD and 92 control subjects were included in this cross-sectional study. HDL oxidative index (HOI) was determined spectrophotometrically using a cell-free method in the presence of a fluorescent substrate dichlorofluorescein diacetate (DCFDA). Paraoxonase 1 (PON1) activity, superoxide dismutase (SOD) activity and malondialdehyde (MDA) plasma levels were assessed in both groups. Results: The subjects with impaired HDL anti-oxidative function (HOI≥1) had lower PON1 paraoxonase activity, lower SOD activity, higher MDA levels and higher carotid intima-media thickness (cIMT) values compared to the controls. HDL oxidative index (HOI) was positively correlated with MDA levels and cIMT and negatively correlated with SOD activity. NAFLD patients with HOI≥1 had elevated serum levels of liver enzymes and higher LS values. Conclusions: Alteration in circulating oxidative stress markers may diminish the anti-oxidative function of HDL. Impaired anti-oxidative capacity of HDL might be related to NAFLD severity and subclinical atherosclerosis in NAFLD patients.