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

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.