The association between elevated lipid profile and liver enzymes: a study on Bangladeshi adults (original) (raw)

Dyslipidemia, a major contributor to cardiovascular diseases, is rapidly increasing in Asian countries including Bangladesh. In addition to the cardiovascular system, abnormal lipid levels are also known to cause complications in renal and hepatic systems. The data regarding dyslipidemia and its relationship with liver enzymes are scarce for the Bangladeshi population. Therefore, this study was conducted to estimate the prevalence of dyslipidemia and determine the relationship between lipid profile and liver enzymes in Bangladeshi adults. A total of 405 participants (318 males and 87 females) were enrolled in the study. Serum levels of TG, TC, LDL, HDL and liver enzymes including ALT, AST, GGT and ALP were analyzed using standard methods. Dyslipidemia and liver function tests abnormalities were defined according to the international standard guidelines. The association between elevated lipid profile markers and liver enzyme abnormalities was assessed by logistic regression analysis. Overall, the prevalence of elevated TG, TC, LDL and low HDL were 30.9%, 23.7%, 26.2% and 78.8%, respectively. On the other hand, the prevalence of elevated liver enzymes ALT, AST, GGT and ALP were 18.8%, 21.6%, 12.9% and 21.9%, respectively. Dyslipidemia and liver enzyme abnormalities were higher in diabetic and hypertensive participants than in the healthy participants. About 61% of participants with dyslipidemia had at least one or more elevated liver enzymes. In regression analysis, an independent association was observed between serum GGT and all lipid components. In conclusion, a high prevalence of dyslipidemia and liver enzyme abnormalities were observed among the study participants. Of the four liver enzymes, the serum levels of GGT showed an independent association with all lipid components. Moreover, this study indicates that subjects with dyslipidemia often have a higher chance of having liver diseases than subjects with no dyslipidemia. However, large-scale prospective studies are needed to understand the underlying mechanisms of lipid-induced hepatic dysfunction in the Bangladeshi population. Dyslipidemia is a major contributor to cardiovascular diseases (CVDs) and considered a global public health challenge 1,2. Research over the recent decades has reported an increased prevalence of dyslipidemia among the general population 2. Moreover, an epidemiological shift of dyslipidemia has been observed in developing nations compared to the developed nations 3. Studies from South Asian countries have reported an upward trend of dyslipidemia among the population living in these regions 4-6. Dyslipidemia mediated cardiovascular diseases are the leading cause of death worldwide 7,8. The prevalence of CVDs is rapidly increasing in the Bangladeshi population 9. Dyslipidemias are also known to cause complications in endocrine systems, central nervous system, hepatic and renal systems 10. Although dyslipidemia affects the major organ systems, the liver is considered to be highly affected due to its close association in lipid metabolism. The liver plays a significant role in lipid metabolism by manufacturing, storing, and transporting lipid metabolites 11. Thus, abnormality in the lipid level, can lead to a change in liver metabolism and can damage the hepatic tissue 12. The most common chronic liver disease represented by excess accumulation of lipids in the liver is known as non-alcoholic fatty liver disease (NAFLD). Currently, it is the most common form of hepatic disorder in the developed nations and is predicted to be identical for developing nations in the next decades 13,14. Bangladesh is also experiencing an upward trend of fatty liver diseases, with a current prevalence of NAFLD at 33.8% 15. The liver enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and γ-glutamyltransferase (GGT) are generally applied as a good marker for assessing liver health 16. Serum ALT is considered as a specific marker for hepatic damage and is mainly found in this organ 17-19 , while serum