To investigate the relationship between dyslipidemia and the risk of non-alcoholic fatty liver disease (NAFLD) in adults.

A total of 13 449 individuals with an average age of 37 (31,48) years including 4 815(35.80%) males, who underwent physical examination and had no NAFLD in Tianjin Medical University General Hospital in 2017 were recruited in this prospective study. Participants were followed up till December 31, 2021, and the newly onset NAFLD was defined as endpoint of the study. Cox regression model was used to analyze the correlation between the dyslipidemia and the risk of NAFLD.

The mean follow-up period was 2.80 years with total 37 707 person-years of follow-up. Among 13 449 participants, 2 711 subjects developed NAFLD during the follow-up period with a cumulative incidence rate of 20.2%. After adjusting for confounding factors, compared with the non-dyslipidemia group, the hazard ratio (HR) (95%CI) of the 1, 2, and 3 types of dyslipidemia groups were 1.388 (1.253-1.538), 1.200 (1.143-1.261) and 1.282 (1.226-1.342), respectively (trend test: P<0.001); and the HR (95%CI) of the hypercholesterolemia, hypertriglyceridemia, mixed hyperlipidemia and low high-density lipoprotein cholesterolemia groups were 1.165 (1.058-1.283), 1.436 (1.345-1.533), 1.291 (1.240-1.344) and 1.068 (1.014-1.124) respectively (all P<0.05). After adjusting for confounding factors, compared with the normal triglycerides group, HR (95%CI) of moderately elevated triglycerides and elevated triglycerides group were 1.774 (1.590-1.980) and 1.443 (1.345-1.549) respectively (trend test: P<0.001).

Dyslipidemia can increase the risk of NAFLD, especially for individuals with hypertriglyceridemia, which indicates that appropriate management of blood lipid levels, especially triglyceride level may effectively prevent NAFLD.

Non-alcoholic fatty liver disease; Dyslipidemias; Disease risk