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One of the underlying drivers is dyslipidemia. We assessed lipid and lipoprotein levels and the relationship between alcohol use and atherogenic lipid profiles, specifically small dense low\u2010density lipoprotein cholesterol (sdLDL\u2010C), in Latinos with and without HCV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From June 1, 2002, to January 1, 2016, 150 Latino adults underwent demographic, clinical, metabolic, lipid\/lipoprotein, and genetic evaluations. Linear regression (adjusted for age, sex, and recent alcohol use) assessed factors associated with sdLDL\u2010C.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participant characteristics were as follows: median age 44\u2009years, 64% male, 39% HCV+, and alcohol use in the last 12\u2009months was 19% heavy and 47% moderate. Ancestries were as follows: 52% European, 40% Native American (NA), and 4.3% African. 29% had non\u2010CC <jats:italic>PNPLA3<\/jats:italic>, 89% non\u2010CC <jats:italic>TM6SF2<\/jats:italic>, and 73% non\u2010CC <jats:italic>IL\u201028b<\/jats:italic> genotypes. High\u2010density lipoprotein (HDL) cholesterol, HDL\u20103, apolipoprotein A\u20101, and lipoprotein\u2010associated phospholipase A2 levels differed by alcohol use groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). On multivariable analysis, female sex (est. \u20136.08, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), HCV+ status (est. \u20138.49, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and heavy alcohol use (vs. none) (est. \u20134.32, <jats:italic>p<\/jats:italic>\u2009=\u20090.03) were associated with lower, while NA ancestry (est. 0.92; <jats:italic>p<\/jats:italic>\u2009=\u20090.01) and adipose tissue insulin resistance (est. 3.30, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were associated with higher sdLDL\u2010C levels. The positive association between NA ancestry and sdLDL\u2010C was dampened by the presence of a non\u2010CC <jats:italic>IL28b<\/jats:italic> genotype (interaction est. \u22121.95, <jats:italic>p<\/jats:italic>\u2009=\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this Latino cohort, ancestry and metabolic dysfunction, independent of alcohol use and HCV, were associated with atherogenic risk. In addition to HCV treatment in this population, cardiometabolic health should be optimized.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.70010","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T05:28:34Z","timestamp":1741757314000},"page":"792-803","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the impact of graded alcohol use on atherogenic lipid profiles among Latinos with underlying chronic liver disease"],"prefix":"10.1111","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1181-0669","authenticated-orcid":false,"given":"Shyam","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Medicine California Pacific Medical Center  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Bull","sequence":"additional","affiliation":[{"name":"Institute for Human Genetics University of California, San Francisco  San Francisco California USA"},{"name":"Division of Gastroenterology and Hepatology, Department of Medicine University of California, San Francisco  San Francisco California USA"},{"name":"UCSF Liver Center University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kian","family":"Salimi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy M.","family":"Shui","sequence":"additional","affiliation":[{"name":"UCSF Liver Center University of California, San Francisco  San Francisco California USA"},{"name":"Department of Epidemiology and Biostatistics University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Siao","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine University of California, San Francisco  San Francisco California USA"},{"name":"UCSF Liver Center University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bokun","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacquelyn J.","family":"Maher","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine University of California, San Francisco  San Francisco California USA"},{"name":"UCSF Liver Center University of California, San 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