Lipoprotein Levels in Early Adulthood and NAFLD in Midlife: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Sahil Khanna, John T. Wilkins, Hongyan Ning, Norrina B. Allen, Cora E. Lewis, J. Jeffrey Carr, Donald Lloyd-Jones, Lisa B. Vanwagner*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective. We evaluated the association of apolipoprotein B (apoB) with low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and triglycerides (TG) in early adulthood with concordant/discordant associations and midlife NAFLD. Methods. Participants from the CARDIA study were included (n = 2,655; baseline mean age: 25.0, 59.1% female, and 48.6% black). NAFLD was defined as liver attenuation ≤40 Hounsfield units after excluding other causes of liver fat. Logistic regression models assessed the odds of Y25 NAFLD among tertiles of apoB, LDL-C, non-HDL-C, and TG and quartiles of the apoB/TG ratio. Discordance/concordance analyses examined the association of apoB with each lipid marker and Y25 NAFLD. Results. The Y25 NAFLD prevalence was 10%. The high-tertile TG group (OR 1.87, 95% CI, and 1.30-2.69) and the low- (OR 1.98, 95% CI, and 1.30-3.01) and middle-apoB/TG ratio groups (OR 1.78, 95% CI, and 1.17-2.72) had the greatest odds of midlife NAFLD. Using discordance/concordance analysis, the high-apoB/high-TG group had the highest odds of NAFLD (OR 1.69, 95% CI, and 1.09-2.61) followed by the low-apoB/high-TG group. The high apoB/low TG group had the lowest odds of NAFLD. Conclusions. Among the studied lipid markers in early adulthood, TG levels have the strongest and most consistent association with midlife NAFLD.

Original languageEnglish (US)
Article number1727711
JournalJournal of Nutrition and Metabolism
StatePublished - 2022

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Food Science
  • Nutrition and Dietetics


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