Fatty liver index and atherogenic risk determined by lipoprotein particle subclasses: a cross-sectional study of middle- to older-aged adults

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dc.contributor.authorMillar, Seán R.
dc.contributor.authorPerry, Ivan J.
dc.contributor.authorPhillips, Catherine M.
dc.contributor.funderHealth Research Board
dc.date.accessioned2026-10-21T15:23:01Z
dc.date.available2026-10-21T15:23:01Z
dc.date.issued2026-09-17
dc.description.abstractBACKGROUND The fatty liver index (FLI) provides a cost-effective way to screen for metabolic dysfunction-associated steatotic liver disease (MASLD). MASLD is associated with preclinical atherosclerosis, with cardiovascular disease (CVD) mortality being the leading cause of death among MASLD patients. OBJECTIVE Lipoprotein particles can provide better CVD risk prediction than traditional lipid measures. Yet, FLI associations with intermediate disease markers remain under-researched. This study addressed this gap by investigating FLI relationships with lipoprotein particle subclass concentrations. METHODS This was a cross-sectional study of 1713 middle-aged to older-aged men and women randomly selected from a large primary care center. The FLI was calculated using triglyceride, body mass index, waist circumference, and gamma-glutamyl transferase levels. Lipoprotein particle subclass concentrations and size were determined using nuclear magnetic resonance spectroscopy. Linear regression analyses examined FLI associations with lipoprotein biomarkers. RESULTS In fully adjusted models, higher FLI scores were associated with larger very low-density lipoprotein (VLDL) and smaller low-density lipoprotein (LDL) and high-density lipoprotein (HDL) particle size, more large and medium VLDL, small LDL, and less large HDL particle concentrations, and greater lipoprotein-related insulin resistance (all P <.001). In models that examined these variable associations across FLI quintiles, significant dose-response relationships were observed (P trend <.001 for all). CONCLUSION These findings support the clinical utility of the FLI as a marker of atherogenic risk and as a tool for identifying at-risk individuals. Incorporating the FLI into CVD risk assessment may help improve risk prediction in individuals with liver disease and guide targeted interventions.en
dc.description.sponsorshipHealth Research Board|HRC/2007/13
dc.description.versionPublished Version
dc.format.extent12
dc.format.mimetypeapplication/pdfen
dc.identifier.authororcidMillar, Seán R.§0000-0003-4453-8446
dc.identifier.authororcidPerry, Ivan J.
dc.identifier.authororcidPhillips, Catherine M.
dc.identifier.citationMillar, S R, Perry, I J & Phillips, C M 2026, 'Fatty liver index and atherogenic risk determined by lipoprotein particle subclasses: a cross-sectional study of middle- to older-aged adults', Journal of Clinical Lipidology, pp. 1-12. https://doi.org/10.1016/j.jacl.2026.09.007
dc.identifier.doi10.1016/j.jacl.2026.09.007
dc.identifier.endpage12
dc.identifier.issn1933-2874
dc.identifier.journaltitleJournal of Clinical Lipidology
dc.identifier.otherORCID: /0000-0003-4453-8446/work/227055540
dc.identifier.startpage1
dc.identifier.urihttps://hdl.handle.net/10468/19487
dc.language.isound
dc.publisherElsevier Ltd
dc.relation.urihttps://doi.org/10.1016/j.jacl.2026.09.007
dc.rights© 2026, the Author(s). Published by Elsevier Inc. on behalf of National Lipid Association. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
dc.rights.accessrightsopen access
dc.rights.licensenameAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.statusPeer reviewed
dc.subjectFatty liver index
dc.subjectLipoprotein
dc.subjectParticles
dc.subjectSubclasses
dc.subjectCardiovascular disease
dc.subject[PublicHealth]
dc.titleFatty liver index and atherogenic risk determined by lipoprotein particle subclasses: a cross-sectional study of middle- to older-aged adults
dc.typeArticle (peer-reviewed)
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