Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Iran.
School of Medicine, Arak University of Medical Sciences, Arak, Iran.
Can J Gastroenterol Hepatol. 2022 Sep 10;2022:1554079. doi: 10.1155/2022/1554079. eCollection 2022.
Nonalcoholic steatohepatitis (NASH) and liver fibrosis are the most common complications of nonalcoholic fatty liver disease (NAFLD). In this systematic review and meta-analysis, we aim to analyze the current literature to evaluate the association of neutrophil to lymphocyte ratio (NLR) with NASH and fibrosis in patients with NAFLD.
PubMed, Web of Science, and Scopus were used to conduct a systematic search for relevant publications published before May 24, 2022. The Newcastle-Ottawa scale was used for quality assessment.
Thirteen studies were included in our study. The pooled results showed that NAFLD patients with significant NASH had elevated levels of NLR compared to those with nonsignificant or without NASH (SMD = 0.97, 95% CI = 0.59-1.39, < 0.001). The pooled sensitivity and specificity of NLR were 78.16% (95% CI = 73.70%-82.04%), and 76.93% (95% CI = 70.22%-82.50%), respectively. In addition, NAFLD patients with significant liver fibrosis had elevated levels of NLR compared to those with nonsignificant or without fibrosis (SMD = 1.59, 95% CI = 0.76-2.43, < 0.001). The pooled sensitivity and specificity of NLR were 82.62% (95% CI = 70.235%-90.55%) and 81.22% (95% CI = 75.62%-85.78%), respectively.
Our findings support NLR to be a promising biomarker that can be readily integrated into clinical settings to aid in the prediction and prevention of NASH and fibrosis among patients with NAFLD.
非酒精性脂肪性肝炎（NASH）和肝纤维化是非酒精性脂肪性肝病（NAFLD）最常见的并发症。在本系统评价和荟萃分析中，我们旨在分析当前文献，以评估中性粒细胞与淋巴细胞比值（NLR）与 NAFLD 患者的 NASH 和纤维化的相关性。
使用 PubMed、Web of Science 和 Scopus 进行系统检索，检索时间截至 2022 年 5 月 24 日之前发表的相关文献。使用 Newcastle-Ottawa 量表进行质量评估。
共有 13 项研究纳入本研究。汇总结果显示，与无或无显著 NASH 的 NAFLD 患者相比，有显著 NASH 的 NAFLD 患者的 NLR 水平升高（SMD=0.97，95%CI=0.59-1.39， < 0.001）。NLR 的汇总敏感性和特异性分别为 78.16%（95%CI=73.70%-82.04%）和 76.93%（95%CI=70.22%-82.50%）。此外，与无或无显著纤维化的 NAFLD 患者相比，有显著纤维化的 NAFLD 患者的 NLR 水平升高（SMD=1.59，95%CI=0.76-2.43， < 0.001）。NLR 的汇总敏感性和特异性分别为 82.62%（95%CI=70.235%-90.55%）和 81.22%（95%CI=75.62%-85.78%）。
我们的研究结果支持 NLR 是一种有前途的生物标志物，可以很容易地整合到临床环境中，以帮助预测和预防 NAFLD 患者的 NASH 和纤维化。
