Liu Ying, Zhong Zhifang, Li Zhihong, Li Xin, Zhang Shengkun, Sun Jie, Zhai Jingfang, Liu Xuekui, Liu Min
Department of Ultrasound, Xuzhou Central Hospital, Xuzhou, People's Republic of China.
Department of Obstetrical and Gynecological, Xuzhou Central hospital, Xuzhou, People's Republic of China.
Risk Manag Healthc Policy. 2022 Aug 23;15:1561-1568. doi: 10.2147/RMHP.S368369. eCollection 2022.
Exposure to famine in early life has been shown to increase the prevalence of non-alcoholic fatty liver disease (NAFLD). Neutrophil-to-lymphocyte ratio (NLR) is a risk factor for developing NAFLD. However, it is not clear that the association between NLR and NAFLD in individuals who were exposed to famine in early life.
To match for age, we selected two group populations from Xuzhou city, China, on two different occasions, 2013 and 2017. The group recruited in 2013 included participants who were born during a period of great famine in China. Participants in the another group recruited in 2017 were born between 1965 and 1968. Clinical characteristics of individuals as well as serology indexes were examined for all participants. Ultrasonography to diagnose NAFLD was performed by trained doctors. A total of 10,574 participants were included in the final analysis.
Individuals born during the famine period have a higher NAFLD prevalence than those who had not been exposed to famine and these findings were similar for both sexes (male: 57.6% vs 48.9%, female: 47.6% vs 40.3%). The prevalence of NAFLD according to NLR quartiles in those exposed to famine was 49.5%, 52.7%, 52.9% and 55.5% for Q1, Q2, Q3 and Q4 NLR, respectively, and was higher than that in non-exposed to famine group. After adjusting for age, BMI, and other metabolic variables, the association between NLR and NAFLD disappeared in the non-famine group. The non-linear relationship between NLR and NAFLD was found in those who had been exposed to famine.
Individuals who were exposed to famine in early life have a higher prevalence of NAFLD than those who were not exposed. Compared with lower NLR levels, elevated NLR is a risk factor for developing NAFLD. However, there is a non-linear relationship between NLR and the risk of developing NAFLD.
早年暴露于饥荒环境已被证明会增加非酒精性脂肪性肝病（NAFLD）的患病率。中性粒细胞与淋巴细胞比值（NLR）是发生NAFLD的一个危险因素。然而，早年暴露于饥荒的个体中NLR与NAFLD之间的关联尚不清楚。
为匹配年龄，我们于2013年和2017年在中国徐州市分两次选取了两组人群。2013年招募的组包括在中国大饥荒时期出生的参与者。2017年招募的另一组参与者出生于1965年至1968年之间。对所有参与者检查了个体的临床特征以及血清学指标。由经过培训的医生进行超声检查以诊断NAFLD。最终分析纳入了10574名参与者。
饥荒时期出生的个体NAFLD患病率高于未暴露于饥荒的个体，且男女情况相似（男性：57.6%对48.9%，女性：47.6%对40.3%）。在暴露于饥荒的人群中，根据NLR四分位数划分的NAFLD患病率，NLR Q1、Q2、Q3和Q4分别为49.5%、52.7%、52.9%和55.5%，高于未暴露于饥荒组。在调整年龄、体重指数和其他代谢变量后，非饥荒组中NLR与NAFLD之间的关联消失。在暴露于饥荒的人群中发现了NLR与NAFLD之间的非线性关系。
早年暴露于饥荒的个体NAFLD患病率高于未暴露者。与较低的NLR水平相比，NLR升高是发生NAFLD的一个危险因素。然而，NLR与发生NAFLD的风险之间存在非线性关系。
