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Remnant cholesterol is independently associated with liver fibrosis in metabolic dysfunction-associated fatty liver disease patients and rats
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  • Published: 29 May 2026

Remnant cholesterol is independently associated with liver fibrosis in metabolic dysfunction-associated fatty liver disease patients and rats

  • Ruifang Li1,2 na1,
  • Rong Ren1 na1,
  • Guifeng Li1 na1,
  • Ping Han3,
  • Lili Zhao2 &
  • …
  • Jia Li2,3 

Scientific Reports (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Diseases
  • Gastroenterology
  • Medical research
  • Risk factors

Abstract

Few studies have explored the relationship between remnant cholesterol (RC) and liver fibrosis in metabolic dysfunction-associated fatty liver disease (MAFLD). Therefore, this study aims to explore the association between RC levels and liver fibrosis in both biopsy-proven MAFLD population and Sprague-Dawley (SD) rats. This current study included 280 participants and 15 SD rats. For MAFLD population, all participants underwent liver biopsy and blood tests. Logistic regression analysis was used to evaluate the association between RC and liver fibrosis and the diagnostic capability of RC was assessed using receiver operating characteristic (ROC) curve analysis. For MAFLD rats, pathological and hematological analysis were used to study the association between RC and liver fibrosis. In the MAFLD population, RC remained significantly associated with liver fibrosis after adjustment for confounding factors (OR:1.21, 95% confidence interval [CI]: 1.09–1.49, p < 0.001). In addition, RC and liver fibrosis remained significantly associated with liver fibrosis when triglycerides (TGs) levels were less than 1.7 mmol/L (OR: 1.13, 95% CI: 1.03–1.56, p = 0.006), low-density lipoprotein cholesterol (LDL-C) levels were less than 3.4 mmol/L (OR: 1.18, 95% CI: 1.08–1.43, p < 0.001), or HDL-C (high-density lipoprotein cholesterol) levels were more than 1.0 mmol/L (OR: 1.20, 95% CI: 1.08–1.47, p < 0.001). In the MAFLD rats, rats with fibrosis exhibited higher RC levels (p < 0.001) and elevated RC was significantly correlated with liver fibrosis (r = 0.819, p < 0.001). Higher RC level is significantly correlated with liver fibrosis in the MAFLD population and rats.

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Funding

This work was funded by the Tianjin Health Science and Technology Project (No. TJWJ2021ZD010), Tianjin Key Medical Discipline Construction Project (Grant No. TJYXZDXK-3-019B) and Tianjin Education Commission Research Project (Nos. 2022KJ275 and 2023KJ014).

Author information

Author notes
  1. These authors contributed equally: Ruifang Li, Rong Ren and Guifeng Li.

Authors and Affiliations

  1. The Second People’s Hospital Affiliated to Tianjin Medical University, Tianjin, 300192, China

    Ruifang Li, Rong Ren & Guifeng Li

  2. Department of Gastroenterology and Hepatology, Tianjin Second People’s Hospital, Tianjin, 300192, China

    Ruifang Li, Lili Zhao & Jia Li

  3. Department of Hepatology and Gastroenterology, Tianjin First Central Hospital, Tianjin, 300192, China

    Ping Han & Jia Li

Authors
  1. Ruifang Li
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  2. Rong Ren
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  3. Guifeng Li
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  4. Ping Han
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  5. Lili Zhao
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  6. Jia Li
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Corresponding authors

Correspondence to Lili Zhao or Jia Li.

Ethics declarations

Ethics approval and consent to participate

This study protocol was approved by the Ethics Committee of Tianjin Second People’s Hospital and was conducted in accordance with the principles of the Declaration of Helsinki. We obtained written informed consent from all the patients, and the IRB approval number is No. [2021]55. The animal experiments were approved by the Animal Experimentation Ethics Committee of Nankai University, and the animal study approval number is 2021-SYDWLL-000338.

Competing interests

The authors declare no competing interests.

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Cite this article

Li, R., Ren, R., Li, G. et al. Remnant cholesterol is independently associated with liver fibrosis in metabolic dysfunction-associated fatty liver disease patients and rats. Sci Rep (2026). https://doi.org/10.1038/s41598-026-46177-7

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  • Received: 01 July 2025

  • Accepted: 24 March 2026

  • Published: 29 May 2026

  • DOI: https://doi.org/10.1038/s41598-026-46177-7

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Keywords

  • Metabolic dysfunction-associated fatty liver disease
  • Remnant cholesterol
  • Liver fibrosis
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