Systemic immune-inflammatory biomarkers (SII, NLR, PLR and LMR) linked to non-alcoholic fatty liver disease risk

Abstract

BackgroundSystemic immune-inflammatory biomarkers including systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have been demonstrated to be associated with the risk and severity of various liver diseases. However, studies on their role and clinical significance in metabolic diseases, especially in nonalcoholic fatty liver disease (NAFLD), are limited and results are inconsistent.Methods10821 adults aged 20 years or older were enrolled in this cross-sectional study, sourced from six cycles of the National Health and Nutrition Examination Survey (NHANES). Survey-weighted logistic regression was employed to investigate the correlation between systemic immune-inflammatory biomarkers (SII, NLR, PLR, and LMR) and NAFLD risk. Restricted cubic spline regression models and segmented regression models were used to describe nonlinear relationships and threshold effects. Subgroup and sensitivity analyses were also conducted.ResultsAfter adjusting for all confounding variables, there was a significant positive association observed between ln-transformed SII (OR= 1.46, 95% CI: 1.27-1.69, P <0.001), NLR (OR= 1.25, 95% CI: 1.05-1.49, P =0.015), LMR (OR= 1.39, 95% CI: 1.14-1.69, P = 0.002) with NAFLD. A nonlinear dose-response relationship with an inverted “U”-shaped threshold of 4.64 was observed between ln(PLR) and NAFLD risk. When ln(PLR) was below 4.64, each unit increase in ln(PLR) was associated with a 0.55-fold increase in the risk of NAFLD (OR= 1.55, 95% CI: 1.05-2.31, P <0.05). Conversely, when ln(PLR) exceeded 4.64, each unit increase in ln(PLR) was associated with a 0.40-fold decrease in the risk of NAFLD (OR= 0.60, 95% CI. 0.44-0.81, P <0.05).Conclusionln-transformed SII, NLR, and LMR were linearly associated with NAFLD risk. ln(PLR) showed an inverted “U”-shaped nonlinear dose-response relationship with the risk of NAFLD.

Systemic immune-inflammation index mediates the association between metabolic dysfunction-associated fatty liver disease and sub-clinical carotid atherosclerosis: a mediation analysis

“…For instance, Liu et al. revealed a significant positive association observed between ln (SII) and NAFLD risk (OR=1.46, 95% CI: 1.27–1.69, P < 0.001), establishing a linear relationship between ln (SII) and NAFLD in a cohort of 10,821 adults from six cycles of the NHANES ( 30 ). Several large cohort studies have demonstrated that an elevated SII is independently associated with an increased risk of CVD mortality ( 31 – 33 ).…”

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“…Previous studies have demonstrated a positive correlation between SII and increased risk of NAFLD and CVD mortality. For instance, Liu et al revealed a significant positive association observed between ln (SII) and NAFLD risk (OR=1.46, 95% CI: 1.27-1.69, P <0.001), establishing a linear relationship between ln (SII) and NAFLD in a cohort of 10,821 adults from six cycles of the NHANES (30). Several large cohort studies have demonstrated that an elevated SII is independently associated with an increased risk of CVD mortality (31)(32)(33).…”

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“…Previous studies have demonstrated a positive correlation between SII and increased risk of NAFLD and CVD mortality. For instance, Liu et al revealed a significant positive association observed between ln (SII) and NAFLD risk (OR=1.46, 95% CI: 1.27-1.69, P <0.001), establishing a linear relationship between ln (SII) and NAFLD in a cohort of 10,821 adults from six cycles of the NHANES (30). Several large cohort studies have demonstrated that an elevated SII is independently associated with an increased risk of CVD mortality (31)(32)(33).…”