Remnant cholesterol is independently associated with liver fibrosis in metabolic dysfunction-associated fatty liver disease patients and rats

Few studies have explored the relationship between remnant cholesterol (RC) and liver fibrosis in metabolic dysfunction-associated fatty liver disease (MAFLD). Therefore, this study aims to explore the association between RC levels and liver fibrosis in both biopsy-proven MAFLD population and Sprague-Dawley (SD) rats. This current study included 280 participants and 15 SD rats. For MAFLD population, all participants underwent liver biopsy and blood tests. Logistic regression analysis was used to evaluate the association between RC and liver fibrosis and the diagnostic capability of RC was assessed using receiver operating characteristic (ROC) curve analysis. For MAFLD rats, pathological and hematological analysis were used to study the association between RC and liver fibrosis. In the MAFLD population, RC remained significantly associated with liver fibrosis after adjustment for confounding factors (OR:1.21, 95% confidence interval [CI]: 1.09-1.49, p < 0.001). In addition, RC and liver fibrosis remained significantly associated with liver fibrosis when triglycerides (TGs) levels were less than 1.7 mmol/L (OR: 1.13, 95% CI: 1.03-1.56, p = 0.006), low-density lipoprotein cholesterol (LDL-C) levels were less than 3.4 mmol/L (OR: 1.18, 95% CI: 1.08-1.43, p < 0.001), or HDL-C (high-density lipoprotein cholesterol) levels were more than 1.0 mmol/L (OR: 1.20, 95% CI: 1.08-1.47, p < 0.001). In the MAFLD rats, rats with fibrosis exhibited higher RC levels (p < 0.001) and elevated RC was significantly correlated with liver fibrosis (r = 0.819, p < 0.001). Higher RC level is significantly correlated with liver fibrosis in the MAFLD population and rats.