COMMENT:
The population prevalence of non-alcoholic fatty liver disease (NAFLD) is indicative of a pandemic, warranting its status as a public health priority. This may explain the disproportionate cardiovascular disease risk noted in NAFLD patients. In an attempt to elucidate its pathophysiology, lipidomic analyses have identified NAFLD-specific whole serum/plasma lipids, but have primarily focused on triglycerides. Other lipid classes’ role in NAFLD’s onset and progression remains to be clarified.
This study aimed to document the quantitative and qualitative lipidomic differences in the whole serum and HDL of 109 patients across the NAFLD spectrum.
Key learnings:
Compared to controls, NAFLD patients exhibited quantitative and qualitative reductions in four phospholipid (PL) classes: phosphatidylcholines (PC), phosphatidylethanolamines (PE), phosphatidylglycerols (PG), and sphingomyelins (SM). Low PC, PE, and SM levels were attributed to a depletion in their polyunsaturated fatty acid (PUFA) components in NAFLD patients’ whole serum and HDL. NAFLD patients also possessed dysregulated free fatty acids (FFA) levels. Importantly, most PUFA-containing lipid species (PUFA-PL and PUFA-FFA) negatively correlated with BMI, insulin resistance, triglycerides, and hepatocyte ballooning. These findings suggest that impairments in HDL may contribute to NAFLD development and progression in insulin resistance states. Future studies must elaborate on these discoveries, confirming clear causative associations between lipid levels and disease states.
