中性粒细胞与高密度脂蛋白胆固醇比值与非酒精性脂肪性肝病或代谢功能障碍相关脂肪性肝病的关联：来自2017 - 2020年美国国家健康与营养检查调查（NHANES）的证据
Association between neutrophil-to-high-density lipoprotein cholesterol ratio and non-alcoholic fatty liver disease or metabolic dysfunction-associated steatotic liver disease: evidence from NHANES 2017-2020.
作者信息
Zhu Na, Li Yanyan, Lin Yingying, Cui XinYu, Li Xin
机构信息
Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, China.
Center of Integrative Medicine, Peking University Ditan Teaching Hospital, Beijing, China.
出版信息
Front Med (Lausanne). 2025 Jan 15;11:1491858. doi: 10.3389/fmed.2024.1491858. eCollection 2024.
BACKGROUND
Non-alcoholic fatty liver disease (NAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD) is closely associated with chronic inflammation and lipid metabolism disorders. The neutrophil-to-high-density lipoprotein cholesterol ratio (NHR) is an integrative marker reflecting inflammatory responses and lipid metabolism disorders and is associated with various diseases. This cross-sectional study aimed to determine the association between NHR and NAFLD, MASLD, and liver fibrosis.
METHODS
Data for this study were obtained from the 2017-2020 National Health and Nutrition Examination Survey (NHANES), we employed weighted multiple regression and restricted cubic spline (RCS) analysis to assess the relationship between NHR and NAFLD, MASLD, and liver fibrosis. Additionally, we performed stratified analyses based on gender, age, body mass index, diabetes, hypertension, smoking status, and history of cardiovascular disease to evaluate the consistency of these associations across different subgroups.
RESULTS
A total of 6,526 participants were included in the study. 2,839 (weighted 44.1%) participants were diagnosed with NAFLD and 2,813 (weighted 43.7%) participants were diagnosed with MASLD. After adjusting for confounders, NHR was positively associated with the risk of NAFLD/MASLD, and the correlation was particularly significant in the subgroups of females, those without hypertension, and those without diabetes ( < 0.05). By the NHR quartile, the risk of NAFLD/MASLD increased progressively with higher NHR levels (P for trend <0.001). In addition, RCS analysis showed a nonlinear association between NHR and NAFLD/MASLD and liver fibrosis (P-non-linear <0.05).
CONCLUSION
NHR may serve as a potential marker for NAFLD/MASLD and liver fibrosis, and lowering NHR levels could help reduce the incidence of these conditions.
背景
非酒精性脂肪性肝病（NAFLD）或代谢功能障碍相关脂肪性肝病（MASLD）与慢性炎症和脂质代谢紊乱密切相关。中性粒细胞与高密度脂蛋白胆固醇比值（NHR）是反映炎症反应和脂质代谢紊乱的综合标志物，与多种疾病相关。这项横断面研究旨在确定NHR与NAFLD、MASLD和肝纤维化之间的关联。
方法
本研究的数据来自2017 - 2020年国家健康与营养检查调查（NHANES），我们采用加权多元回归和受限立方样条（RCS）分析来评估NHR与NAFLD、MASLD和肝纤维化之间的关系。此外，我们根据性别、年龄、体重指数、糖尿病、高血压、吸烟状况和心血管疾病史进行分层分析，以评估这些关联在不同亚组中的一致性。
结果
本研究共纳入6526名参与者。2839名（加权44.1%）参与者被诊断为NAFLD，2813名（加权43.7%）参与者被诊断为MASLD。在调整混杂因素后，NHR与NAFLD/MASLD的风险呈正相关，且在女性亚组、无高血压亚组和无糖尿病亚组中相关性尤为显著（<0.05）。按NHR四分位数划分，NAFLD/MASLD的风险随着NHR水平升高而逐渐增加（趋势P<0.001）。此外，RCS分析显示NHR与NAFLD/MASLD和肝纤维化之间存在非线性关联（非线性P<0.05）。
结论
NHR可能作为NAFLD/MASLD和肝纤维化的潜在标志物，降低NHR水平可能有助于降低这些疾病的发生率。
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