Jian Jieming, Zhang Rui, Dong Yuan, Zheng Hongting, Liao Xiaoyu
Department of Endocrinology, Translational Research of Diabetes Key Laboratory of Chongqing Education Commission of China, the Second Affiliated Hospital of Army Medical University, Chongqing, 400037, China.
Lipids Health Dis. 2025 Jan 7;24(1):6. doi: 10.1186/s12944-024-02427-z.
Nutrition and its associated inflammation have been acknowledged as vital factors in the etiopathogenesis of non-alcoholic fatty liver disease (NAFLD) and liver fibrosis. The nutritional risk index (NRI) has been widely recognized as a valid indicator of nutritional status in several diseases, including osteoporosis and cardiovascular disease. However, the role of NRI in NAFLD and liver fibrosis remains unclear.
Participants were selected from the National Health and Nutrition Examination Survey data for the 2017-2018 cycle. Association between NRI and both NAFLD and liver fibrosis was evaluated using multiple logistic regression and restricted cubic spline (RCS) analysis. Mediation analysis was employed to assess the influence of inflammation on the association between NRI and both NAFLD and liver fibrosis.
Compared to their respective control groups, individuals with NAFLD and liver fibrosis exhibited higher NRI levels. Multiple logistic regression analyses indicated that NRI was positively associated with the odds of NAFLD and liver fibrosis across both continuous scales and quantile groups, with adjustments for relevant covariables. The RCS model demonstrated a dose-response effect between NRI and the odds of NAFLD, but not with liver fibrosis. Receiver operating characteristic (ROC) analysis revealed the area under the ROC curves of 0.798 and 0.775 for NAFLD and liver fibrosis, respectively. Mediation analysis showed that inflammation accounted for 3.139% of the effect of NRI on the odds of NAFLD, suggesting inflammation might partially mediate the impact of NRI on NAFLD.
Our findings indicate that NRI may serve as a potential associated marker for these liver diseases, underscoring the importance of nutritional status in their etiopathogenesis.
营养及其相关炎症已被公认为是非酒精性脂肪性肝病（NAFLD）和肝纤维化发病机制中的重要因素。营养风险指数（NRI）在包括骨质疏松症和心血管疾病在内的多种疾病中已被广泛认可为营养状况的有效指标。然而，NRI在NAFLD和肝纤维化中的作用仍不清楚。
参与者选自2017 - 2018周期的美国国家健康和营养检查调查数据。使用多重逻辑回归和受限立方样条（RCS）分析评估NRI与NAFLD和肝纤维化之间的关联。采用中介分析来评估炎症对NRI与NAFLD和肝纤维化之间关联的影响。
与各自的对照组相比，患有NAFLD和肝纤维化的个体表现出更高的NRI水平。多重逻辑回归分析表明，在连续量表和分位数组中，调整相关协变量后，NRI与NAFLD和肝纤维化的几率呈正相关。RCS模型显示NRI与NAFLD几率之间存在剂量反应效应，但与肝纤维化无关。受试者工作特征（ROC）分析显示，NAFLD和肝纤维化的ROC曲线下面积分别为0.798和0.775。中介分析表明，炎症占NRI对NAFLD几率影响的3.139%，表明炎症可能部分介导了NRI对NAFLD的影响。
我们的研究结果表明，NRI可能作为这些肝脏疾病的潜在相关标志物，强调了营养状况在其发病机制中的重要性。
