{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:54:04Z","timestamp":1782910444308,"version":"3.54.5"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T00:00:00Z","timestamp":1710288000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T00:00:00Z","timestamp":1710288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Natural Science Funding of China","award":["82272598"],"award-info":[{"award-number":["82272598"]}]},{"name":"Natural Science Foundation of Guangdong Province, China","award":["2020A1515011203"],"award-info":[{"award-number":["2020A1515011203"]}]},{"name":"Science, Technology, and Innovation Commission of Shenzhen","award":["JCYJ20210324135804012"],"award-info":[{"award-number":["JCYJ20210324135804012"]}]},{"name":"the Science, Technology, and Innovation Commission of Shenzhen","award":["JCYJ20220530150407015"],"award-info":[{"award-number":["JCYJ20220530150407015"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>There is limited research on the association between the alanine aminotransferase to high-density lipoprotein cholesterol ratio (ALT\/HDL-C) ratio and nonalcoholic fatty liver disease (NAFLD). The purpose of the current research was to look into the connection between the ALT\/HDL-C ratio and the risk of NAFLD in lean Chinese individuals. Between January 2010 and December 2014, 11,975 non-obese people participated in this prospective cohort research. The relationship between the ALT\/HDL-C ratio and the risk of developing NAFLD was assessed using the Cox proportional-hazards regression model, Cox proportional hazards regression with cubic spline functions and smooth curve fitting, sensitivity analysis, and subgroup analyses. The ALT\/HDL-C ratio\u2019s potential value as a NAFLD prognostic marker was to be evaluated using the receiver operating characteristic curve analysis. A total of 5419 (45.253%) women comprised the research's participant population, and the research participants\u2019 average age was 43.278\u2009\u00b1\u200914.941\u00a0years. The ALT\/HDL-C ratio was 11.607 (7.973\u201317.422) at the median (interquartile ranges). 2087 (17.428%) patients had NAFLD diagnoses throughout a median follow-up of 24.967\u00a0months. The study's findings demonstrated a positive connection between the ALT\/AHDL-C ratio and the incident NAFLD (HR\u2009=\u20091.037, 95% CI: 1.031\u20131.042) when adjusting for relevant factors. The ALT\/HDL-C ratio and NAFLD risk had a nonlinear connection, with 12.963 as the ratio's inflection point. Effect sizes (HR) were 1.023 (95% CI: 1.017\u20131.029) and 1.204 (95% CI: 1.171\u20131.237), respectively, on the right and left sides of the inflection point. The sensitivity analysis also showed how reliable our findings were. According to subgroup analysis, those with BMI\u00a0&lt;\u00a024\u00a0kg\/m<jats:sup>2<\/jats:sup> and DBP\u2009&lt;\u200990\u00a0mmHg had a stronger correlation between the ALT\/HDL-C ratio and NAFLD risk. The current study shows a positive and non-linear connection between the ALT\/HDL-C ratio and NAFLD risk in lean Chinese individuals. When the ALT\/HDL-C ratio is less than 12.963, it is significantly linked to NAFLD. Therefore, from a therapy standpoint, it is advised to keep the ALT\/HDL-C ratio less than the inflection point.<\/jats:p>","DOI":"10.1038\/s41598-024-56555-8","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T08:32:56Z","timestamp":1710318776000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Association between alanine aminotransferase to high-density lipoprotein cholesterol ratio and nonalcoholic fatty liver disease: a retrospective cohort study in lean Chinese individuals"],"prefix":"10.1038","volume":"14","author":[{"given":"Changchun","family":"Cao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihe","family":"Mo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haofei","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dehua","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongcheng","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"56555_CR1","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/837419","volume":"2010","author":"E Hijona","year":"2010","unstructured":"Hijona, E., Hijona, L., Arenas, J. I. & Bujanda, L. Inflammatory mediators of hepatic steatosis. Mediat. Inflamm. 2010, 837419. https:\/\/doi.org\/10.1155\/2010\/837419 (2010).","journal-title":"Mediat. Inflamm."},{"issue":"6","key":"56555_CR2","doi-asserted-by":"publisher","first-page":"1828","DOI":"10.1053\/j.gastro.2018.08.024","volume":"155","author":"F Kanwal","year":"2018","unstructured":"Kanwal, F. et al. Risk of hepatocellular cancer in patients with non-alcoholic fatty liver disease. Gastroenterology 155(6), 1828-1837.e2. https:\/\/doi.org\/10.1053\/j.gastro.2018.08.024 (2018).","journal-title":"Gastroenterology"},{"issue":"9","key":"56555_CR3","doi-asserted-by":"publisher","first-page":"1626","DOI":"10.1111\/jgh.14608","volume":"34","author":"K Kodama","year":"2019","unstructured":"Kodama, K. et al. Clinical features of hepatocellular carcinoma in nonalcoholic fatty liver disease patients without advanced fibrosis. J. Gastroenterol. Hepatol. 34(9), 1626\u20131632. https:\/\/doi.org\/10.1111\/jgh.14608 (2019).","journal-title":"J. Gastroenterol. Hepatol."},{"issue":"2","key":"56555_CR4","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1002\/hep.23280","volume":"51","author":"E Fabbrini","year":"2010","unstructured":"Fabbrini, E., Sullivan, S. & Klein, S. Obesity and nonalcoholic fatty liver disease: Biochemical, metabolic, and clinical implications. Hepatology 51(2), 679\u2013689. https:\/\/doi.org\/10.1002\/hep.23280 (2010).","journal-title":"Hepatology"},{"issue":"9","key":"56555_CR5","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.1038\/ajg.2015.235","volume":"110","author":"JL Wei","year":"2015","unstructured":"Wei, J. L. et al. Prevalence and severity of nonalcoholic fatty liver disease in non-obese patients: A population study using proton-magnetic resonance spectroscopy. Am. J. Gastroenterol. 110(9), 1306\u20131314. https:\/\/doi.org\/10.1038\/ajg.2015.235 (2015) (quiz 1315).","journal-title":"Am. J. Gastroenterol."},{"issue":"10","key":"56555_CR6","doi-asserted-by":"publisher","first-page":"1555","DOI":"10.1111\/j.1440-1746.2012.07222.x","volume":"27","author":"CJ Liu","year":"2012","unstructured":"Liu, C. J. Prevalence and risk factors for non-alcoholic fatty liver disease in Asian people who are not obese. J. Gastroenterol. Hepatol. 27(10), 1555\u20131560. https:\/\/doi.org\/10.1111\/j.1440-1746.2012.07222.x (2012).","journal-title":"J. Gastroenterol. Hepatol."},{"issue":"5","key":"56555_CR7","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.1002\/hep.23567","volume":"51","author":"K Das","year":"2010","unstructured":"Das, K. et al. Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease. Hepatology 51(5), 1593\u20131602. https:\/\/doi.org\/10.1002\/hep.23567 (2010).","journal-title":"Hepatology"},{"issue":"11","key":"56555_CR8","doi-asserted-by":"publisher","first-page":"1935","DOI":"10.3390\/medicina59111935","volume":"59","author":"L Abenavoli","year":"2023","unstructured":"Abenavoli, L. et al. Ultrasound prevalence and clinical features of nonalcoholic fatty liver disease in patients with inflammatory bowel diseases: A real-life cross-sectional study. Medicina (Kaunas) 59(11), 1935. https:\/\/doi.org\/10.3390\/medicina59111935 (2023).","journal-title":"Medicina (Kaunas)"},{"issue":"1","key":"56555_CR9","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1093\/aje\/kws448","volume":"178","author":"M Lazo","year":"2013","unstructured":"Lazo, M. et al. Prevalence of nonalcoholic fatty liver disease in the United States: The Third National Health and Nutrition Examination Survey, 1988\u20131994. Am. J. Epidemiol. 178(1), 38\u201345. https:\/\/doi.org\/10.1093\/aje\/kws448 (2013).","journal-title":"Am. J. Epidemiol."},{"issue":"4","key":"56555_CR10","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.jhepr.2019.08.002","volume":"1","author":"S Albhaisi","year":"2019","unstructured":"Albhaisi, S., Chowdhury, A. & Sanyal, A. J. Non-alcoholic fatty liver disease in lean individuals. JHEP Rep. 1(4), 329\u2013341. https:\/\/doi.org\/10.1016\/j.jhepr.2019.08.002 (2019).","journal-title":"JHEP Rep."},{"issue":"4","key":"56555_CR11","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1016\/j.jhep.2017.06.003","volume":"67","author":"JG Fan","year":"2017","unstructured":"Fan, J. G., Kim, S. U. & Wong, V. W. New trends on obesity and NAFLD in Asia. J. Hepatol. 67(4), 862\u2013873. https:\/\/doi.org\/10.1016\/j.jhep.2017.06.003 (2017).","journal-title":"J. Hepatol."},{"issue":"1","key":"56555_CR12","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1002\/hep4.1143","volume":"2","author":"LB VanWagner","year":"2018","unstructured":"VanWagner, L. B. & Armstrong, M. J. Lean NAFLD: A not so benign condition?. Hepatol. Commun. 2(1), 5\u20138. https:\/\/doi.org\/10.1002\/hep4.1143 (2018).","journal-title":"Hepatol. Commun."},{"issue":"1","key":"56555_CR13","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1002\/hep4.1124","volume":"2","author":"H Hagstrom","year":"2018","unstructured":"Hagstrom, H. et al. Risk for development of severe liver disease in lean patients with nonalcoholic fatty liver disease: A long-term follow-up study. Hepatol. Commun. 2(1), 48\u201357. https:\/\/doi.org\/10.1002\/hep4.1124 (2018).","journal-title":"Hepatol. Commun."},{"issue":"18","key":"56555_CR14","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000006712","volume":"96","author":"H Yoshitaka","year":"2017","unstructured":"Yoshitaka, H. et al. Nonoverweight nonalcoholic fatty liver disease and incident cardiovascular disease: A post hoc analysis of a cohort study. Medicine (Baltimore) 96(18), e6712. https:\/\/doi.org\/10.1097\/MD.0000000000006712 (2017).","journal-title":"Medicine (Baltimore)"},{"issue":"2","key":"56555_CR15","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1111\/liv.12912","volume":"36","author":"T Fukuda","year":"2016","unstructured":"Fukuda, T. et al. The impact of non-alcoholic fatty liver disease on incident type 2 diabetes mellitus in non-overweight individuals. Liver Int. 36(2), 275\u2013283. https:\/\/doi.org\/10.1111\/liv.12912 (2016).","journal-title":"Liver Int."},{"issue":"12","key":"56555_CR16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0115403","volume":"9","author":"K Imajo","year":"2014","unstructured":"Imajo, K. et al. LDL-migration index (LDL-MI), an indicator of small dense low-density lipoprotein (sdLDL), is higher in non-alcoholic steatohepatitis than in non-alcoholic fatty liver: A multicenter cross-sectional study. PLoS\u00a0One 9(12), e115403. https:\/\/doi.org\/10.1371\/journal.pone.0115403 (2014).","journal-title":"PLoS\u00a0One"},{"issue":"7","key":"56555_CR17","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.1038\/oby.2011.21","volume":"19","author":"AL Norris","year":"2011","unstructured":"Norris, A. L. et al. Circulating oxidized LDL and inflammation in extreme pediatric obesity. Obesity (Silver Spring) 19(7), 1415\u20131419. https:\/\/doi.org\/10.1038\/oby.2011.21 (2011).","journal-title":"Obesity (Silver Spring)"},{"issue":"5","key":"56555_CR18","doi-asserted-by":"publisher","first-page":"5728","DOI":"10.18632\/oncotarget.6799","volume":"7","author":"DQ Sun","year":"2016","unstructured":"Sun, D. Q. et al. Increased levels of low-density lipoprotein cholesterol within the normal range as a risk factor for nonalcoholic fatty liver disease. Oncotarget 7(5), 5728\u20135737. https:\/\/doi.org\/10.18632\/oncotarget.6799 (2016).","journal-title":"Oncotarget"},{"key":"56555_CR19","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.995749","volume":"9","author":"Q Li","year":"2022","unstructured":"Li, Q., Han, Y., Hu, H. & Zhuge, Y. Gamma-glutamyl transferase to high-density lipoprotein cholesterol ratio has a non-linear association with non-alcoholic fatty liver disease: A secondary prospective cohort study in non-obese Chinese adults. Front. Med. (Lausanne) 9, 995749. https:\/\/doi.org\/10.3389\/fmed.2022.995749 (2022).","journal-title":"Front. Med. (Lausanne)"},{"key":"56555_CR20","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.13022","volume":"10","author":"M Wang","year":"2022","unstructured":"Wang, M. et al. A combined association of serum uric acid, alanine aminotransferase and waist circumference with non-alcoholic fatty liver disease: A community-based study. PeerJ 10, e13022. https:\/\/doi.org\/10.7717\/peerj.13022 (2022).","journal-title":"PeerJ"},{"issue":"5","key":"56555_CR21","doi-asserted-by":"publisher","first-page":"260","DOI":"10.14740\/gr685w","volume":"8","author":"MA Cruz","year":"2015","unstructured":"Cruz, M. A. et al. Association of the nonalcoholic hepatic steatosis and its degrees with the values of liver enzymes and homeostasis model assessment-insulin resistance index. Gastroenterol. Res. 8(5), 260\u2013264. https:\/\/doi.org\/10.14740\/gr685w (2015).","journal-title":"Gastroenterol. Res."},{"issue":"3","key":"56555_CR22","doi-asserted-by":"publisher","first-page":"923","DOI":"10.4103\/jfmpc.jfmpc_243_18","volume":"8","author":"R Mansour-Ghanaei","year":"2019","unstructured":"Mansour-Ghanaei, R., Mansour-Ghanaei, F., Naghipour, M. & Joukar, F. Biochemical markers and lipid profile in nonalcoholic fatty liver disease patients in the PERSIAN Guilan cohort study (PGCS), Iran. J. Family Med. Prim. Care 8(3), 923\u2013928. https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_243_18 (2019).","journal-title":"J. Family Med. Prim. Care"},{"issue":"11","key":"56555_CR23","doi-asserted-by":"publisher","first-page":"2975","DOI":"10.21037\/jtd.2016.11.67","volume":"8","author":"K Tziomalos","year":"2016","unstructured":"Tziomalos, K. High-density lipoprotein: Quantity or quality?. J. Thorac. Dis. 8(11), 2975\u20132977. https:\/\/doi.org\/10.21037\/jtd.2016.11.67 (2016).","journal-title":"J. Thorac. Dis."},{"issue":"16","key":"56555_CR24","doi-asserted-by":"publisher","first-page":"1640","DOI":"10.1161\/CIRCULATIONAHA.109.192644","volume":"120","author":"KG Alberti","year":"2009","unstructured":"Alberti, K. G. et al. Harmonizing the metabolic syndrome: A joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation 120(16), 1640\u20131645. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.109.192644 (2009).","journal-title":"Circulation"},{"issue":"1","key":"56555_CR25","first-page":"129","volume":"58","author":"P Socha","year":"2007","unstructured":"Socha, P. et al. Nonalcoholic fatty liver disease as a feature of the metabolic syndrome. Rocz Panstw Zakl Hig 58(1), 129\u2013137 (2007).","journal-title":"Rocz Panstw Zakl Hig"},{"issue":"3","key":"56555_CR26","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1002\/hep.32728","volume":"77","author":"J Xie","year":"2023","unstructured":"Xie, J. et al. The associations between modifiable risk factors and nonalcoholic fatty liver disease: A comprehensive Mendelian randomization study. Hepatology 77(3), 949\u2013964. https:\/\/doi.org\/10.1002\/hep.32728 (2023).","journal-title":"Hepatology"},{"issue":"1","key":"56555_CR27","doi-asserted-by":"publisher","first-page":"124","DOI":"10.1186\/s12902-023-01382-7","volume":"23","author":"C Cao","year":"2023","unstructured":"Cao, C. et al. The nonlinear correlation between alanine aminotransferase to high-density lipoprotein cholesterol ratio and the risk of diabetes: A historical Japanese cohort study. BMC Endocr. Disord. 23(1), 124. https:\/\/doi.org\/10.1186\/s12902-023-01382-7 (2023).","journal-title":"BMC Endocr. Disord."},{"issue":"12","key":"56555_CR28","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-013781","volume":"6","author":"DQ Sun","year":"2016","unstructured":"Sun, D. Q. et al. Association of low-density lipoprotein cholesterol within the normal range and NAFLD in the non-obese Chinese population: A cross-sectional and longitudinal study. BMJ Open 6(12), e013781. https:\/\/doi.org\/10.1136\/bmjopen-2016-013781 (2016).","journal-title":"BMJ Open"},{"issue":"2","key":"56555_CR29","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1111\/j.1751-2980.2008.00331.x","volume":"9","author":"MD Zeng","year":"2008","unstructured":"Zeng, M. D. et al. Guidelines for the diagnosis and treatment of nonalcoholic fatty liver diseases. J. Dig. Dis. 9(2), 108\u2013112. https:\/\/doi.org\/10.1111\/j.1751-2980.2008.00331.x (2008).","journal-title":"J. Dig. Dis."},{"issue":"11","key":"56555_CR30","doi-asserted-by":"publisher","first-page":"1265","DOI":"10.1503\/cmaj.110977","volume":"184","author":"RH Groenwold","year":"2012","unstructured":"Groenwold, R. H. et al. Missing covariate data in clinical research: When and when not to use the missing-indicator method for analysis. CMAJ 184(11), 1265\u20131269. https:\/\/doi.org\/10.1503\/cmaj.110977 (2012).","journal-title":"CMAJ"},{"issue":"4","key":"56555_CR31","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1002\/sim.4067","volume":"30","author":"IR White","year":"2011","unstructured":"White, I. R., Royston, P. & Wood, A. M. Multiple imputation using chained equations: Issues and guidance for practice. Stat. Med. 30(4), 377\u2013399. https:\/\/doi.org\/10.1002\/sim.4067 (2011).","journal-title":"Stat. Med."},{"issue":"2","key":"56555_CR32","doi-asserted-by":"publisher","first-page":"R23","DOI":"10.1186\/bcr2564","volume":"12","author":"J Li","year":"2010","unstructured":"Li, J. et al. Effects of childhood body size on breast cancer tumour characteristics. Breast Cancer Res. 12(2), R23. https:\/\/doi.org\/10.1186\/bcr2564 (2010).","journal-title":"Breast Cancer Res."},{"issue":"7","key":"56555_CR33","doi-asserted-by":"publisher","first-page":"3442","DOI":"10.3390\/ijerph18073442","volume":"18","author":"JH Lee","year":"2021","unstructured":"Lee, J. H., Lee, H. S., Cho, A. R., Lee, Y. J. & Kwon, Y. J. Non-alcoholic fatty liver disease is an independent risk factor for LDL cholesterol target level. Int. J. Environ. Res. Public Health 18(7), 3442. https:\/\/doi.org\/10.3390\/ijerph18073442 (2021).","journal-title":"Int. J. Environ. Res. Public Health"},{"issue":"1","key":"56555_CR34","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1186\/s12916-020-01776-7","volume":"18","author":"D Rothenbacher","year":"2020","unstructured":"Rothenbacher, D. et al. Contribution of cystatin C- and creatinine-based definitions of chronic kidney disease to cardiovascular risk assessment in 20 population-based and 3 disease cohorts: The BiomarCaRE project. BMC Med. 18(1), 300. https:\/\/doi.org\/10.1186\/s12916-020-01776-7 (2020).","journal-title":"BMC Med."},{"issue":"3","key":"56555_CR35","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1097\/EDE.0000000000000434","volume":"27","author":"DW Cramer","year":"2016","unstructured":"Cramer, D. W., Vitonis, A. F., Terry, K. L., Welch, W. R. & Titus, L. J. The association between talc use and ovarian cancer: A retrospective case-control study in two US states. Epidemiology 27(3), 334\u2013346. https:\/\/doi.org\/10.1097\/EDE.0000000000000434 (2016).","journal-title":"Epidemiology"},{"issue":"4","key":"56555_CR36","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1111\/j.1440-1746.2010.06509.x","volume":"26","author":"XH Hou","year":"2011","unstructured":"Hou, X. H. et al. Non-alcoholic fatty liver disease\u2019s prevalence and impact on alanine aminotransferase associated with metabolic syndrome in the Chinese. J. Gastroenterol. Hepatol. 26(4), 722\u2013730. https:\/\/doi.org\/10.1111\/j.1440-1746.2010.06509.x (2011).","journal-title":"J. Gastroenterol. Hepatol."},{"issue":"6","key":"56555_CR37","doi-asserted-by":"publisher","first-page":"1889","DOI":"10.2337\/diabetes.51.6.1889","volume":"51","author":"B Vozarova","year":"2002","unstructured":"Vozarova, B. et al. High alanine aminotransferase is associated with decreased hepatic insulin sensitivity and predicts the development of type 2 diabetes. Diabetes 51(6), 1889\u20131895. https:\/\/doi.org\/10.2337\/diabetes.51.6.1889 (2002).","journal-title":"Diabetes"},{"issue":"29","key":"56555_CR38","doi-asserted-by":"publisher","first-page":"3775","DOI":"10.3748\/wjg.v18.i29.3775","volume":"18","author":"S Sookoian","year":"2012","unstructured":"Sookoian, S. & Pirola, C. J. Alanine and aspartate aminotransferase and glutamine-cycling pathway: Their roles in pathogenesis of metabolic syndrome. World J. Gastroenterol. 18(29), 3775\u20133781. https:\/\/doi.org\/10.3748\/wjg.v18.i29.3775 (2012).","journal-title":"World J. Gastroenterol."},{"key":"56555_CR39","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1186\/s12906-015-0871-5","volume":"15","author":"KA Hwang","year":"2015","unstructured":"Hwang, K. A., Hwang, Y. J., Kim, G. R. & Choe, J. S. Extracts from Aralia elata (Miq) seem alleviate hepatosteatosis via improving hepatic insulin sensitivity. BMC Complement Altern. Med. 15, 347. https:\/\/doi.org\/10.1186\/s12906-015-0871-5 (2015).","journal-title":"BMC Complement Altern. Med."},{"issue":"1","key":"56555_CR40","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1002\/hep.23623","volume":"52","author":"G Musso","year":"2010","unstructured":"Musso, G., Gambino, R., Cassader, M. & Pagano, G. A meta-analysis of randomized trials for the treatment of nonalcoholic fatty liver disease. Hepatology 52(1), 79\u2013104. https:\/\/doi.org\/10.1002\/hep.23623 (2010).","journal-title":"Hepatology"},{"issue":"2","key":"56555_CR41","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.hepres.2005.09.019","volume":"33","author":"I Sakaida","year":"2005","unstructured":"Sakaida, I. & Okita, K. The role of oxidative stress in NASH and fatty liver model. Hepatol. Res. 33(2), 128\u2013131. https:\/\/doi.org\/10.1016\/j.hepres.2005.09.019 (2005).","journal-title":"Hepatol. Res."},{"issue":"1","key":"56555_CR42","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1186\/s13098-021-00741-5","volume":"13","author":"S Karami","year":"2021","unstructured":"Karami, S. et al. Association of anti-oxidative capacity of HDL with subclinical atherosclerosis in subjects with and without non-alcoholic fatty liver disease. Diabetol. Metab. Syndr. 13(1), 121. https:\/\/doi.org\/10.1186\/s13098-021-00741-5 (2021).","journal-title":"Diabetol. Metab. Syndr."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-56555-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-56555-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-56555-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T08:37:11Z","timestamp":1710319031000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-56555-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,13]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["56555"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-56555-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,13]]},"assertion":[{"value":"12 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"6056"}}