The correlation between neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with nonalcoholic fatty liver disease: a cross-sectional study

Abstract

Objective The aim of this study is to investigate the correlation between neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with nonalcoholic fatty liver disease (NAFLD). Methods All subjects underwent medical check-ups, which included the measurement of basic clinical, biochemical tests and imaging tests. Univariate and multivariate logistic regression models and piece-wise linear regression were used to assess the relationship between NLR and PLR with NAFLD. Results All participants were divided into two groups: the Non-NAFLD group and the NAFLD group. Univariate analysis model indicated PLR was negatively correlated with NAFLD (P < 0.001) and NLR was not significantly associated with NAFLD (P > 0.05). Multiple logistic regression showed that no correlation between NLR and PLR with NAFLD after adjusting all covariates (P > 0.05). Interestingly, a nonlinear association was detected between NLR and PLR with NAFLD by piece-wise linear regression adjusting for all confounding factors. The inflection points of NLR and PLR were 1.23 and 42.29, respectively. On the left side of the inflection point (NLR < 1.23), a positive correlation was detected between NLR and NAFLD (β = 2.35, 95% CI: 1.20~4.61, P = 0.013). And PLR was found to be negatively associated with NAFLD on the right side of the inflection point (β = 0.99, 95% CI: 0.98~0.99, P < 0.001). Conclusion This study demonstrated that the relationship between NLR and PLR with NAFLD was nonlinear after adjusting for potential confounding factors. The result suggested that PLR ≥ 42.29 might be a protective factor of NAFLD, while NLR < 1.23 might be a risk factor of NAFLD.

The Association of Nonalcoholic Fatty Liver Disease With Neutrophil-to-Lymphocyte Ratio and Neutrophil-Percentage-to-Albumin Ratio

“…Some studies have reported a statistically significant relationship [12,17,28], indicating that NLR values were higher in individuals with hepatic steatosis. However, contrasting findings have also been reported in certain other studies, where no significant association between NLR and hepatic steatosis was observed [29,30]. Zhou et al [30] found that NLR was not significantly correlated with NAFLD.…”

“…However, contrasting findings have also been reported in certain other studies, where no significant association between NLR and hepatic steatosis was observed [29,30]. Zhou et al [30] found that NLR was not significantly correlated with NAFLD. In contrast, a recent study focusing on assessing the diagnostic efficacy of the NLR as a marker for steatosis observed that NLR exhibited a significant positive correlation with the intensity of steatosis [21].…”

Low-Cost Predictors for Liver Function and Clinical Outcomes after Sustained Virological Response in Patients with HCV-Related Cirrhosis and Thrombocytopenia

“…We acknowledge the limits of our sample size: this was a pilot study. Platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios are markers of systemic immune response that could be potentially used as prognostic for HCV infection severity [ 57 ], for HCC outcomes [ 58 ] and also for a range of other chronic hepatic diseases [ 59 , 60 ]. Dyslipidaemia [ 61 , 62 ] and insulin resistance [ 63 ] were also previously associated with the severity of HCV complications.…”

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

“…Multiple immune cell types are involved in the development of the disease, associated with the severity of hepatic steatosis, fibrosis, inflammation, and cellular injury ( 19 ). Systemic immune-inflammatory biomarkers include the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), which reflect the balance of immune response and the overall inflammatory environment ( 20 , 21 ). Additionally, the systemic immune inflammation index (SII) is a comprehensive novel biomarker of inflammation that reflects both localized immune responses and the overall level of inflammation in the body ( 22 ).…”

“…Previous studies have reported associations between these immune-inflammatory markers and the risk and severity of various liver diseases, such as viral hepatitis, cirrhosis, and hepatocellular carcinoma ( 23 , 24 ). However, there is limited research and inconsistent results regarding the role and clinical significance of SII, NLR, PLR, and LMR in NAFLD ( 20 , 21 , 25 ).…”