与非酒精性脂肪性肝病风险相关的系统性免疫炎症生物标志物（SII、NLR、PLR 和 LMR）。
Systemic immune-inflammatory biomarkers (SII, NLR, PLR and LMR) linked to non-alcoholic fatty liver disease risk.
机构信息
Department of Respiratory Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
The National Clinical Trial Center of Chinese Medicine, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
出版信息
Front Immunol. 2024 Feb 28;15:1337241. doi: 10.3389/fimmu.2024.1337241. eCollection 2024.
BACKGROUND
Systemic 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.
METHODS
10821 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.
RESULTS
After 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, 0.001), NLR (OR= 1.25, 95% CI: 1.05-1.49, =0.015), LMR (OR= 1.39, 95% CI: 1.14-1.69, = 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, 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, 0.05).
CONCLUSION
ln-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.
背景
系统性免疫炎症生物标志物，包括全身免疫炎症指数（SII）、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），已被证明与各种肝病的风险和严重程度相关。然而，关于它们在代谢性疾病中的作用和临床意义的研究，特别是在非酒精性脂肪性肝病（NAFLD）中的研究还很有限，结果也不一致。
方法
本横断面研究纳入了 6 个周期国家健康和营养检查调查（NHANES）中年龄在 20 岁及以上的 10821 名成年人。采用调查加权逻辑回归来研究系统性免疫炎症生物标志物（SII、NLR、PLR 和 LMR）与 NAFLD 风险之间的相关性。采用限制性立方样条回归模型和分段回归模型来描述非线性关系和阈值效应。还进行了亚组和敏感性分析。
结果
在调整了所有混杂变量后，ln 转换后的 SII（比值比[OR]=1.46，95%置信区间[CI]：1.27-1.69，<0.001）、NLR（OR=1.25，95%CI：1.05-1.49，=0.015）和 LMR（OR=1.39，95%CI：1.14-1.69，=0.002）与 NAFLD 呈显著正相关。ln（PLR）与 NAFLD 风险之间存在非线性剂量反应关系，呈倒“U”型阈值为 4.64。当 ln（PLR）低于 4.64 时，ln（PLR）每增加一个单位，NAFLD 的风险增加 0.55 倍（OR=1.55，95%CI：1.05-2.31，=0.05）。相反，当 ln（PLR）超过 4.64 时，ln（PLR）每增加一个单位，NAFLD 的风险降低 0.40 倍（OR=0.60，95%CI：0.44-0.81，=0.05）。
结论
ln 转换后的 SII、NLR 和 LMR 与 NAFLD 风险呈线性相关。ln（PLR）与 NAFLD 风险呈倒“U”型非线性剂量反应关系。
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