Elevated GGT to HDL ratio as a marker for the risk of NAFLD and liver fibrosis

Sci Rep. 2025 Jan 2;15(1):10. doi: 10.1038/s41598-024-84649-w.

Abstract

This study investigated the association between NAFLD and liver fibrosis and the ratio of gamma-glutamyl transferase to high-density lipoprotein cholesterol (GGT/HDL-C). In this cross-sectional study, we included 4764 subjects who participated in the National Health and Nutrition Examination Survey (NHANES) during 2017-2018. Adjusted multivariate logistic regression analysis was utilized to evaluate the relationships between GGT/HDL-C levels and NAFLD, fatty liver degree, and liver fibrosis. The non-linear link between NAFLD and the GGT/HDL-C ratio was examined using generalized additive models. There was a non-linear association between GGT/HDL-C and the risk of NAFLD, and all regression models demonstrated a strong relationship between GGT/HDL-C levels and the risk of liver fibrosis, the degree of hepatic steatosis, and the prevalence of NAFLD. Subgroup analyses revealed a significant correlation between the risk of NAFLD and the GGT/HDL-C ratio among Mexican Americans and young people in the 20-40 age range. The receiver operating characteristic (ROC) study showed that GGT/HDL-C was a more accurate predictor of NAFLD than GGT or HDL-C alone. In the U.S. population, an increased risk of NAFLD, the severity of hepatic steatosis, and the risk of liver fibrosis are independently correlated with an elevated GGT/HDL-C ratio.

Keywords: Fibrosis; Gamma-glutamyl transferase; High-density lipoprotein cholesterol; NAFLD; Steatosis.

MeSH terms

  • Adult
  • Aged
  • Biomarkers* / blood
  • Cholesterol, HDL* / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Liver Cirrhosis* / blood
  • Liver Cirrhosis* / epidemiology
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease* / blood
  • Non-alcoholic Fatty Liver Disease* / epidemiology
  • Nutrition Surveys
  • ROC Curve
  • Risk Factors
  • Young Adult
  • gamma-Glutamyltransferase* / blood

Substances

  • gamma-Glutamyltransferase
  • Cholesterol, HDL
  • Biomarkers