Association between hepatic steatosis and lipoprotein(a) levels in non-alcoholic patients: A systematic review

• Published in: Indian journal of gastroenterology Vol. 43; no. 3; pp. 536 - 547
• Main Authors: Masson, Walter, Barbagelata, Leandro, Godinez-Leiva, Eddison, Genua, Idoia, Nogueira, Juan Patricio
• Format: Journal Article
• Language: English
• Published: New Delhi Springer India 01-06-2024
• Subjects: Adult; Biomarkers - blood; Fatty Liver - blood; Female; Gastroenterology; Hepatology; Humans; Lipoprotein(a) - blood; Liver Cirrhosis - blood; Male; Medicine; Medicine & Public Health; Middle Aged; Non-alcoholic Fatty Liver Disease - blood; Non-alcoholic Fatty Liver Disease - complications; Systematic Review; Lipoprotein(a); Fatty liver; Liver diseases; Cardiovascular risk factors; Steatohepatitis; Systematic review; Lipoprotein; Metabolic-associated fatty liver disease; Metabolism; Non-alcoholic fatty liver disease
• ISSN: 0254-8860; 0975-0711; 0975-0711
• DOI: 10.1007/s12664-023-01457-2

Background and Objectives
It is well known that lipid abnormalities exist in the context of non-alcoholic fatty liver disease (NAFLD). The association between lipoprotein(a) [Lp(a)] levels and NAFLD is poorly understood. The main objective of the present study was to assess the association between Lp(a) levels and NAFLD.
Methods
This systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO CRD42023392526). A literature search was performed to detect studies that evaluated the association between Lp(a) levels, NAFLD and steatohepatitis (NASH).
Results
Ten observational studies, including 40,045 patients, were identified and considered eligible for this systematic review. There were 9266 subjects in the NAFLD groups and 30,779 individuals in the respective control groups. Five studies evaluated patients with NAFLD (hepatic steatosis was associated with lower Lp(a) levels in four studies, while the remaining showed opposite results). Two studies evaluating NASH patients showed that Lp(a) levels were not different compared to controls. However, the increment of Lp(a) levels was correlated with liver fibrosis in one of them. In addition, one study analyzed simultaneously patients with NAFLD and NASH, showing a neutral result in NAFLD patients and a positive relationship in NASH patients. Two studies that included patients with the new definition of metabolic-associated fatty liver disease (MAFLD) also showed neutral results.
Conclusion
Although there could be an association between Lp(a) levels and hepatic steatosis, the results of the studies published to date are contradictory and not definitive.
Graphical Abstract