全免疫炎症值与代谢功能障碍相关脂肪性肝病的关联：2017 - 2020年美国国家健康与营养检查调查结果

Association of pan-immune-inflammatory value with metabolic dysfunction-associated steatotic liver disease: findings from NHANES 2017-2020.

作者信息

Huang Lian-Zhen, Ni Ze-Bin, Yao Qi-Rong, Huang Wei-Feng, Li Ji, Wang Yan-Qing, Zhang Jin-Yan

机构信息

Department of Gastroenterology and Hepatology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, No. 55 Zhenhai Road, Xiamen, 361003, China.

The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.

出版信息

BMC Gastroenterol. 2025 Jan 3;25(1):4. doi: 10.1186/s12876-024-03584-2.

DOI:10.1186/s12876-024-03584-2

PMID:39754093

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11697488/

Abstract

BACKGROUND

Metabolic dysfunction-associated steatotic liver disease (MASLD) has become the most common chronic liver disease worldwide. The pan-immune-inflammation value (PIV) has been proposed as a biomarker for assessing immune status and inflammation. There is currently no evidence regarding the effect of PIV on the risk of MASLD. This study aimed to investigate the association between PIV and MASLD.

METHODS

The cross-sectional study included 6462 adults aged ≥ 20 years from the National Health and Nutrition Examination Survey 2017-2020. PIV was calculated based on blood count data. Weighted multivariable logistic regression was employed to calculate the odds ratio (OR) and 95% confidence interval (CI) to investigate the association of PIV and MASLD. Restricted cubic spline (RCS) analysis was conducted to explore the dose-response relationship between PIV and MASLD. Stratified and sensitivity analyses were performed to confirm the robustness of our findings.

RESULTS

Among 6462 participants, 2458 were diagnosed with MASLD. Positive associations between LnPIV and MASLD were observed in all three models (Model 1: OR = 1.46, 95% CI: 1.28-1.66, P < 0.001; Model 2: OR = 1.41, 95% CI: 1.24-1.60, P < 0.001; Model 3: OR = 1.39, 95% CI: 1.16-1.65, P = 0.004). When PIV was classified into quartiles, both Q3 and Q4 exhibited significantly increased risks of MASLD compared with the reference Q1 in full adjusted Model 3 (Q3: OR = 1.63, 95% CI: 1.20-2.22, P = 0.012; Q4: OR = 1.76, 95% CI: 1.28-2.41, P = 0.008; P for trend = 0.002). RCS analysis did not show a nonlinear relationship between LnPIV and MASLD (P = 0.093 for nonlinearity). Stratified analysis showed a consistent positive association between LnPIV and MASLD in all subgroups, and sensitivity analyses supported the reliability of these results.

CONCLUSIONS

Higher PIV levels are significantly associated with an increased prevalence of MASLD, indicating that PIV is a potentially effective inflammatory marker for assessing MASLD in participants.

摘要

背景

代谢功能障碍相关脂肪性肝病（MASLD）已成为全球最常见的慢性肝病。泛免疫炎症值（PIV）已被提议作为评估免疫状态和炎症的生物标志物。目前尚无证据表明PIV对MASLD风险的影响。本研究旨在探讨PIV与MASLD之间的关联。

方法

这项横断面研究纳入了来自2017 - 2020年美国国家健康与营养检查调查的6462名年龄≥20岁的成年人。PIV根据血细胞计数数据计算得出。采用加权多变量逻辑回归计算比值比（OR）和95%置信区间（CI），以研究PIV与MASLD的关联。进行受限立方样条（RCS）分析以探索PIV与MASLD之间的剂量反应关系。进行分层和敏感性分析以确认我们研究结果的稳健性。

结果

在6462名参与者中，2458人被诊断为MASLD。在所有三个模型中均观察到LnPIV与MASLD之间存在正相关（模型1：OR = 1.46，95% CI：1.28 - 1.66，P < 0.001；模型2：OR = 1.41，95% CI：1.24 - 1.60，P < 0.001；模型3：OR = 1.39，95% CI：1.16 - 1.65，P = 0.004）。当将PIV分为四分位数时，在完全调整的模型3中，与参考四分位数Q1相比，Q3和Q4的MASLD风险均显著增加（Q3：OR = 1.63，95% CI：1.20 - 2.22，P = 0.012；Q4：OR = 1.76，95% CI：1.28 - 2.41，P = 0.008；趋势P = 0.002）。RCS分析未显示LnPIV与MASLD之间存在非线性关系（非线性P = 0.093）。分层分析显示在所有亚组中LnPIV与MASLD之间均存在一致的正相关，敏感性分析支持了这些结果的可靠性。