We performed a cross-sectional study on 215 Japanese employees aged 20–68 years to investigate the association between NAFLD and serum phospholipid fatty acid composition. NAFLD was diagnosed by ultrasonography. The fatty acid composition between the control and NAFLD groups was compared, and the inverse probability of treatment weighting (IPTW) was performed to eliminate each confounding effect of sex, smoking status, BMI, insulin resistance, dietary cholesterol, and salt intake. A receiver operating characteristic (ROC) curve analysis was performed to evaluate the NAFLD prediction accuracy of fatty acids. Seventy-one subjects were diagnosed with NAFLD. Their serum phospholipid dihomo-γ-linolenic acid (DGLA) level was significantly higher after adjusting for each variable using IPTW. In the ROC analysis, the ratio of ARA to DGLA had an area under the curve (AUC) of 0.763. By combining the ratio of ARA to DGLA with the ratio of AST to ALT, AUC increased to 0.871. In conclusion, NAFLD subjects in a Japanese working population have higher serum phospholipid DGLA. Results of the IPTW and ROC analysis indicated that serum PL DGLA and the ratio of ARA to DGLA provide diagnosis information on the fatty liver that is different to AST and ALT and improve the accuracy of fatty liver prediction, owning potential value as serum biomarkers.
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