Alteration of lipids in different metabolic disorders

ConditionLipid alterations
ObesityObesity is often associated with dyslipidaemia, which presents as elevated plasma levels of TGs, VLDL, and low HDL values. Every 10 pounds of extra fat increases daily cholesterol production by 10 mg. The lipid profile rises in obese individuals [169].
MASLDHepatic lipid imbalance results from hepatic absorption of FAs and de novo lipogenesis exceeding fatty acid oxidation and lipid export in MASLD. This leads to modifications in the hepatic metabolism of lipids, potentially precipitating severe complications such as cirrhosis and HCC. Different MASLD patients had various levels of serum lysophosphatidylcholine, sphingomyelin, total cholesterol esters, and TAGs [170].
Type II diabetesAnomalies of plasma lipids and lipoprotein associated with type II diabetes include reduced HDL cholesterol, an abundance of small dense LDL particles, and elevated TG levels. Every one of these dyslipidaemia traits is linked to an increased risk of CVD [171].
Type II diabetes with MASLDThere is a bidirectional pathophysiological link between MASLD and type 2 diabetes. On the one hand, the latter encourages the development of MASL into MASH, a more advanced form of the disease. HCC and cirrhosis are two conditions that are made more likely by NASH and may necessitate liver transplantation [172].
MASLD + obesity + type II diabetesThe risk of developing cirrhosis and MASH is significantly increased when type 2 diabetes, obesity, and MASLD are present than when MASLD is present, but chronic hyperglycaemia is not. Whether MASLD is a substantial independent predictor of CVD remains debatable [173].

TGs: triglycerides; VLDL: very low-density lipoprotein; HDL: high-density lipoprotein; MASLD: metabolic dysfunction-associated steatotic liver disease; FAs: fatty acids; HCC: hepatocellular carcinoma; TAGs: triacylglycerols; LDL: low-density lipoprotein; CVD: cardiovascular disease; MASL: metabolic dysfunction-associated steatotic liver; MASH: metabolic dysfunction-associated steatohepatitis; NASH: non-alcoholic steatohepatitis