Remnant cholesterol has a nonlinear association with non-alcoholic fatty liver disease: A secondary retrospective cohort study in non-obese Chinese adults

Abstract Objective Evidence linking non-obese non-alcoholic fatty liver disease (NAFLD) with residual cholesterol (RC) is weak. In this study, Chinese adults who were not obese were examined for a relationship between NAFLD and RC levels. Methods 16,004 non-obese volunteers were included in a retrospective cohort study at a Chinese clinic between the start of 2010 and the end of 2014. The correlation between initial RC levels and the likelihood of developing NAFLD was investigated using the proportional hazards regression (Cox) model. Using cubic spline functions and smooth curve fitting technique, a two-piecewise proportional hazards regression (Cox) method was used to investigate nonlinear associations between RC and NAFLD. There were numerous sensitivity assessments carried out. The information was posted on the DATADRYAD website. Results The results showed a positive correlation between RC and incidence of NAFLD after controlling for variables (HR = 1.061, 95% CI 1.045–1.078). Between RC and NAFLD, a nonlinear connection was found, with a turning point at 98.29 mg/dL. The effect sizes (HR) were 1.150 (95% CI 1.106, 1.194) and 1.009 (95% CI 0.982, 1.037) on either side of the turning point, respectively. A sensitivity examination further supported the stability of the findings. Conclusion In a Chinese sample that is not obese, this research emphasizes a potentially favorable nonlinear connection between RC and NAFLD risk. When RC was below 98.29 mg/dL, RC was substantially associated with the risk of NAFLD. Thus, from a therapeutic standpoint, keeping RC levels below this cutoff would be advantageous.