Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China.
Department of Laboratory Medicine, Sichuan Province Orthopedic Hospital, Chengdu, China.
Front Endocrinol (Lausanne). 2022 Nov 28;13:981196. doi: 10.3389/fendo.2022.981196. eCollection 2022.
There is few effective biomarkers for diagnosing nonalcoholic fatty liver disease (NAFLD) in clinical practice. This study was aimed to investigate the predictive ability of novel inflammatory biomarkers, including the monocyte to high-density lipoprotein cholesterol ratio (MHR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR), for NAFLD.
A total of 4465 outpatients diagnosed with NAFLD and 3683 healthy controls were enrolled between May 2016 and November 2021 from the West China Hospital of Sichuan University, and anthropometric and laboratory examination data were collected. The two-sample Mann-Whitney U test and binary logistic regression analysis were used to evaluate the correlations between four inflammatory biomarkers and NAFLD. The areas under the curves (AUCs) of receiver operating characteristic were used to evaluate their predictive ability for NAFLD.
The MHR, NLR and LMR were higher in patients with NAFLD than in healthy controls (<0.001), whereas the PLR was remarkably lower (<0.001). The OR values of the MHR, NLR, PLR, and LMR were 1.599 (1.543-1.658), 1.250 (1.186-1.317), 0.987(0.986-0.988) and 1.111(1.083-1.139), respectively(<0.001). After adjusting for confounding factors, MHR was still the most relevant risk factor for NAFLD compared with other inflammatory markers (<0.001). The AUCs of the MHR, NLR, PLR, and LMR were as follows: 0.663 (0.651-0.675), 0.524 (0.512-0.537), 0.329 (0.318-0.341), and 0.543 (0.530-0.555), respectively (<0.001). Furthermore, the diagnostic model combining the MHR with alanine aminotransferase, aspartate aminotransferase, total cholesterol, triglycerides, fasting blood glucose, creatinine, uric acid, and body mass index had the best AUC of 0.931 (0.925-0.936).
MHR was superior to NLR, PLR and LMR as an inflammatory biomarker in the prediction of NAFLD. When combined with relevant laboratory parameters, the MHR may improve the clinical noninvasive diagnosis of NAFLD.
目前临床上用于诊断非酒精性脂肪性肝病（NAFLD）的有效生物标志物较少。本研究旨在探讨新型炎症生物标志物（包括单核细胞与高密度脂蛋白胆固醇比值（MHR）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和淋巴细胞与单核细胞比值（LMR））对 NAFLD 的预测能力。
2016 年 5 月至 2021 年 11 月，我们从四川大学华西医院招募了 4465 名被诊断为 NAFLD 的门诊患者和 3683 名健康对照者，并收集了人体测量和实验室检查数据。采用两样本曼-惠特尼 U 检验和二元逻辑回归分析评估了四个炎症生物标志物与 NAFLD 之间的相关性。受试者工作特征曲线下面积（AUCs）用于评估它们对 NAFLD 的预测能力。
与健康对照组相比，NAFLD 患者的 MHR、NLR 和 LMR 更高（<0.001），而 PLR 显著降低（<0.001）。MHR、NLR、PLR 和 LMR 的比值比（OR）值分别为 1.599（1.543-1.658）、1.250（1.186-1.317）、0.987（0.986-0.988）和 1.111（1.083-1.139）（<0.001）。在校正混杂因素后，与其他炎症标志物相比，MHR 仍然是与 NAFLD 最相关的危险因素（<0.001）。MHR、NLR、PLR 和 LMR 的 AUC 分别为：0.663（0.651-0.675）、0.524（0.512-0.537）、0.329（0.318-0.341）和 0.543（0.530-0.555）（<0.001）。此外，将 MHR 与丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆固醇、甘油三酯、空腹血糖、肌酐、尿酸和体重指数相结合的诊断模型具有最佳的 AUC 为 0.931（0.925-0.936）。
MHR 作为一种炎症生物标志物，在预测 NAFLD 方面优于 NLR、PLR 和 LMR。当与相关实验室参数结合使用时，MHR 可能会改善 NAFLD 的临床无创诊断。
