Prevalence of Dyslipidemia in Patients with Non-Alcoholic Steatohepatitis and Its Association with Metabolic Syndrome

Abstract

Non-alcoholic steatohepatitis (NASH) is a progressive form of non-alcoholic fatty liver disease strongly linked with metabolic dysfunction. Objective: To determine the prevalence of dyslipidemia in patients with NASH and evaluate its association with metabolic syndrome. Methods: A cross-sectional analytical study was conducted at Sandeman provincial Hospital (Civil Hospital), Quetta from October 2024 to March 2025. This study conducted on 225 adult patients diagnosed with NASH. Anthropometric measurements, metabolic parameters, and complete lipid profiles were recorded. Dyslipidemia was defined using standard lipid thresholds. Metabolic syndrome was diagnosed using established clinical criteria. Results: Dyslipidemia was present in 181 patients (80.4%). Elevated triglycerides were the most prevalent abnormality (74.7%), followed by low HDL cholesterol (67.5%), elevated total cholesterol (49.8%), and elevated LDL cholesterol (46.2%). Metabolic syndrome was diagnosed in 171 patients (76%). Patients with metabolic syndrome exhibited significantly higher triglyceride levels (214.5 ± 58.2 mg/dL vs. 151.4 ± 42.6 mg/dL), lower HDL cholesterol (37.4 ± 8.1 mg/dL vs. 45.1 ± 9.0 mg/dL), and higher total and LDL cholesterol (p = 0.001–0.004) compared with those without metabolic syndrome. Multivariate analysis demonstrated that metabolic syndrome was an independent predictor of dyslipidemia (adjusted OR 3.42, 95% CI 1.88–6.22). Conclusion: Dyslipidemia is highly prevalent among NASH patients, particularly in those with metabolic syndrome. The strong association between these conditions emphasizes the need for early metabolic screening and integrated management targeting lipid abnormalities, obesity, and insulin resistance to reduce hepatic and cardiovascular complications.