Infection Management Department, The First People's Hospital of Changzhou, Changzhou, China.
Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, China.
Front Immunol. 2024 Jun 24;15:1389967. doi: 10.3389/fimmu.2024.1389967. eCollection 2024.
Although inflammation has been linked to nonalcoholic fatty liver disease (NAFLD), most studies have focused only on a single indicator, leading to inconsistent results. Therefore, a large prospective study that includes a variety of well-documented single and composite indicators of inflammation is needed. This study aimed to thoroughly investigate the potential associations between different systemic inflammatory indicators and NAFLD in the UK Biobank cohort.
After excluding ineligible participants, 378,139 individuals were included in the study. Associations between systemic inflammatory indicators and hepatic steatosis were assessed using multivariate logistic regression. The relationships between systemic inflammatory indicators and nonalcoholic fatty liver disease were analysed using Cox proportional hazards models, and nonlinear associations were investigated using restricted cubic splines.
According to the cross-sectional analysis, systemic inflammatory indicators significantly correlated with hepatic steatosis. Over a median follow-up of 13.9 years, 4,145 individuals developed NAFLD. After sufficient adjustment for confounding factors, CRP levels were found to be nonlinearly positively associated with NAFLD risk (<0.001), representing the strongest correlation among the tested relationships; lymphocyte count and the LMR showed an L-shaped correlation; monocyte count and neutrophil count showed a linear positive correlation (all < 0.001); and the NLR, PLR, and SII showed a U-shaped correlation (all <0.001).
Multiple systemic inflammatory indicators are strongly associated with the development of NAFLD, and aggressive systemic inflammation management may have a favourable impact on reducing the burden of NAFLD; further randomized controlled studies are needed.
尽管炎症与非酒精性脂肪性肝病（NAFLD）有关，但大多数研究仅关注单一指标，导致结果不一致。因此，需要一项包含各种有充分记录的炎症单一和复合指标的大型前瞻性研究。本研究旨在全面探讨英国生物库队列中不同系统性炎症指标与 NAFLD 之间的潜在关联。
排除不合格参与者后，本研究纳入了 378139 名参与者。使用多变量逻辑回归评估系统性炎症指标与肝脂肪变性之间的关联。使用 Cox 比例风险模型分析系统性炎症指标与非酒精性脂肪性肝病之间的关系，并使用限制立方样条曲线探讨非线性关系。
根据横断面分析，系统性炎症指标与肝脂肪变性显著相关。在中位数为 13.9 年的随访期间，有 4145 人发生了 NAFLD。在充分调整混杂因素后，发现 CRP 水平与 NAFLD 风险呈非线性正相关（<0.001），是所测试关系中相关性最强的；淋巴细胞计数和 LMR 呈 L 形相关；单核细胞计数和中性粒细胞计数呈线性正相关（均<0.001）；NLR、PLR 和 SII 呈 U 形相关（均<0.001）。
多种系统性炎症指标与 NAFLD 的发生密切相关，积极的系统性炎症管理可能对降低 NAFLD 负担产生有利影响；需要进一步的随机对照研究。
