Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
European Journal of Medical Research
Published in: European Journal of Medical Research 1/2024

Open Access 01-12-2024 | Fatty Liver | Research

Relationship between albumin-corrected anion gap and non-alcoholic fatty liver disease varied in different waist circumference groups: a cross-sectional study

Authors: Ye Lu, Ya-zhen Zhan, Wan Li, Shu-li Liao

Published in: European Journal of Medical Research | Issue 1/2024

Login to get access

Abstract

Objectives

To investigate the association of albumin-corrected anion gap (ACAG) with non-alcoholic fatty liver disease (NAFLD) and clinically significant fibrosis (CSF) defined by vibration-controlled transient elastography measurements.

Methods

This cross-sectional study including 4531 participants was conducted using the data from the NHANES database of cycles 2017–2018. The outcomes were set as NAFLD vs. non-NAFLD and NAFLD with CSF vs. NAFLD without CSF. The generalized additive model and restricted cubic spline analyses were used to assess the nonlinear relationship. The generalized linear models, logistic regression models, sensitivity analysis, P trend test, subgroup analysis, and mediation analysis were employed to analyze the association. Finally, an ACAG-based model was constructed and evaluated.

Results

A higher ACAG level was an independent risk factor for NAFLD (P < 0.05), but not for CSF (P > 0.05). The sensitivity analysis and P trend test results substantiated the significantly positive relationship between ACAG and NAFLD (P < 0.05). Interestingly, the obvious connection between ACAG and NAFLD varied in different waist circumference groups and played a central role in the central obesity group. In addition, alanine aminotransferase and waist circumference were the mediators in their relationship. Moreover, the ACAG-based model performed well in predicting NAFLD.

Conclusions

ACAG level is independently associated with NAFLD but not CSF. ACAG might be a novel and reliable biomarker for predicting NAFLD clinically especially in the central obesity population.
Appendix
Available only for authorised users
Literature
1.
Stefan N, Kantartzis K, Haring HU. Causes and metabolic consequences of fatty liver. Endocr Rev. 2008;29(7):939–60.CrossRefPubMed
2.
3.
Krupp D, Johner SA, Kalhoff H, Buyken AE, Remer T. Long-term dietary potential renal acid load during adolescence is prospectively associated with indices of nonalcoholic fatty liver disease in young women. J Nutr. 2012;142(2):313–9.CrossRefPubMed
4.
Emamat H, Farhadnejad H, Poustchi H, Teymoori F, Bahrami A, Hekmatdoost A. The association between dietary acid load and odds of non-alcoholic fatty liver disease: a case-control study. Nutr Health. 2023;29(4):637–44.CrossRefPubMed
5.
Raluca Pais A, Barritt S, Calmus Y, Scatton O, Runge T, Lebray P, Poynard T, Ratziu V, Conti F. NAFLD and liver transplantation: current burden and expected challenges. J Hepatol. 2016;65–1245:57.
6.
Hasan KM, Friedman TC, Shao X, Parveen M, Sims C, Lee DL, et al. E-cigarettes and Western diet: important metabolic risk factors for hepatic diseases. Hepatology. 2019;69(6):2442–54.CrossRefPubMed
7.
Xu L, Xu C, Yu C, Miao M, Zhang X, Zhu Z, et al. Association between serum growth hormone levels and nonalcoholic fatty liver disease: a cross-sectional study. PLoS ONE. 2012;7(8): e44136.CrossRefPubMedPubMedCentral
8.
Chen J, Dai C, Yang Y, Wang Y, Zeng R, Li B, et al. The association between anion gap and in-hospital mortality of post-cardiac arrest patients: a retrospective study. Sci Rep. 2022;12(1):7405.CrossRefPubMedPubMedCentral
9.
Pratumvinit B, Lam L, Kongruttanachok N, Hemthong C, Kost GJ, Kamkang P, et al. Anion gap reference intervals show instrument dependence and weak correlation with albumin levels. Clin Chim Acta. 2020;500:172–9.CrossRefPubMed
10.
Li P, Shi L, Yan X, Wang L, Wan D, Zhang Z, et al. Albumin corrected anion gap and the risk of in-hospital mortality in patients with acute pancreatitis: a retrospective cohort study. J Inflamm Res. 2023;16:2415–22.CrossRefPubMedPubMedCentral
11.
Zhong L, Xie B, Ji XW, Yang XH. The association between albumin corrected anion gap and ICU mortality in acute kidney injury patients requiring continuous renal replacement therapy. Intern Emerg Med. 2022;17(8):2315–22.CrossRefPubMedPubMedCentral
12.
Aydin SS, Aksakal E. Relationship between albumin-corrected anion gap and mortality in hospitalized heart failure patients. Cureus. 2023;15(9): e45967.PubMedPubMedCentral
13.
World Stroke O, Sacks D, Baxter B, From the American Association of Neurological Surgeons ASoNC, Interventional Radiology Society of Europe CIRACoNSESoMINTESoNESOSfCA, Interventions SoIRSoNS, et al. Multisociety consensus quality improvement revised consensus statement for endovascular therapy of acute ischemic stroke. Int J Stroke. 2018;13(6):612–32.
14.
Vilar-Gomez E, Nephew LD, Vuppalanchi R, Gawrieh S, Mladenovic A, Pike F, et al. High-quality diet, physical activity, and college education are associated with low risk of NAFLD among the US population. Hepatology. 2022;75(6):1491–506.CrossRefPubMed
15.
Castera L, Friedrich-Rust M, Loomba R. noninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease. Gastroenterology. 2019;156(5):1264–8.CrossRefPubMed
16.
Hatherill M, Waggie Z, Purves L, Reynolds L, Argent A. Correction of the anion gap for albumin in order to detect occult tissue anions in shock. Arch Dis Child. 2002;87(6):526–9.CrossRefPubMedPubMedCentral
17.
Authors Guidelines ESCCfP, Societies ESCNC. ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Atherosclerosis. 2019;2019(290):140–205.
18.
Cotter TG, Rinella M. Nonalcoholic fatty liver disease 2020: the state of the disease. Gastroenterology. 2020;158(7):1851–64.CrossRefPubMed
19.
Saadeh S, Younossi ZM, Remer EM, Gramlich T, Ong JP, Hurley M, et al. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology. 2002;123(3):745–50.CrossRefPubMed
20.
Eddowes PJ, Sasso M, Allison M, Tsochatzis E, Anstee QM, Sheridan D, et al. Accuracy of fibroscan controlled attenuation parameter and liver stiffness measurement in assessing steatosis and fibrosis in patients with nonalcoholic fatty liver disease. Gastroenterology. 2019;156(6):1717–30.CrossRefPubMed
21.
Chan R, Wong VW, Chu WC, Wong GL, Li LS, Leung J, et al. Higher estimated net endogenous acid production may be associated with increased prevalence of nonalcoholic Fatty liver disease in chinese adults in Hong Kong. PLoS ONE. 2015;10(4): e0122406.CrossRefPubMedPubMedCentral
22.
23.
24.
Zou L, Li X, Wu N, Jia P, Liu C, Jia D. Palmitate induces myocardial lipotoxic injury via the endoplasmic reticulum stress-mediated apoptosis pathway. Mol Med Rep. 2017;16(5):6934–9.CrossRefPubMed
25.
Kakisaka K, Cazanave SC, Fingas CD, Guicciardi ME, Bronk SF, Werneburg NW, et al. Mechanisms of lysophosphatidylcholine-induced hepatocyte lipoapoptosis. Am J Physiol Gastrointest Liver Physiol. 2012;302(1):G77-84.CrossRefPubMed
26.
Mota M, Banini BA, Cazanave SC, Sanyal AJ. Molecular mechanisms of lipotoxicity and glucotoxicity in nonalcoholic fatty liver disease. Metabolism. 2016;65(8):1049–61.CrossRefPubMedPubMedCentral
27.
Nowak WN, Deng J, Ruan XZ, Xu Q. Reactive oxygen species generation and atherosclerosis. Arterioscler Thromb Vasc Biol. 2017;37(5):e41–52.CrossRefPubMed
28.
Ashraf NU, Sheikh TA. Endoplasmic reticulum stress and oxidative stress in the pathogenesis of Non-alcoholic fatty liver disease. Free Radic Res. 2015;49(12):1405–18.CrossRefPubMed
29.
Dominguez-Perez M, Simoni-Nieves A, Rosales P, Nuno-Lambarri N, Rosas-Lemus M, Souza V, et al. Cholesterol burden in the liver induces mitochondrial dynamic changes and resistance to apoptosis. J Cell Physiol. 2019;234(5):7213–23.CrossRefPubMed
30.
Lara-Guzman OJ, Gil-Izquierdo A, Medina S, Osorio E, Alvarez-Quintero R, Zuluaga N, et al. Oxidized LDL triggers changes in oxidative stress and inflammatory biomarkers in human macrophages. Redox Biol. 2018;15:1–11.CrossRefPubMed
31.
Friedman SL. Seminars in medicine of the beth Israel Hospital, Boston the cellular basis of hepatic fibrosis mechanisms and treatment strategies. N Engl J Med. 1993;328(25):1828–35.CrossRefPubMed
32.
Peters KM, Wilson RB, Borradaile NM. Non-parenchymal hepatic cell lipotoxicity and the coordinated progression of non-alcoholic fatty liver disease and atherosclerosis. Curr Opin Lipidol. 2018;29(5):417–22.CrossRefPubMedPubMedCentral
Metadata
Title
Relationship between albumin-corrected anion gap and non-alcoholic fatty liver disease varied in different waist circumference groups: a cross-sectional study
Authors
Ye Lu
Ya-zhen Zhan
Wan Li
Shu-li Liao
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Fatty Liver
Published in
European Journal of Medical Research / Issue 1/2024
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-024-01811-w

Other articles of this Issue 1/2024

European Journal of Medical Research 1/2024 Go to the issue

Research

Association between estimated glomerular filtration rate and reversion to normoglycemia in people with impaired fasting glucose: a 5-year retrospective cohort study

Research

Neutrophil lncRNA ZNF100-6:2 is a potential diagnostic marker for active pulmonary tuberculosis

Research

Relationship between lactate-to-albumin ratio and 28-day mortality in patients with exacerbation of chronic obstructive pulmonary disease admitted to the Intensive Care Unit

Research

Dual-energy computed tomography in the early evaluation of acute radiation pneumonia

Research

Identification of potential crucial genes and therapeutic targets for epilepsy

Research

Neuroprotective effects of quinpirole on lithium chloride pilocarpine-induced epilepsy in rats and its underlying mechanisms