Shen Di, Cai Xintian, Hu Junli, Song Shuaiwei, Zhu Qing, Ma Huimin, Zhang Yingying, Ma Rui, Zhou Pan, Yang Wenbo, Hong Jing, Zhang Delian, Li Nanfang
Graduate School, Xinjiang Medical University, Urumqi, Xinjiang, People's Republic of China.
Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region, Hypertension Research Laboratory, Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, People's Republic of China.
J Inflamm Res. 2025 Feb 4;18:1623-1638. doi: 10.2147/JIR.S503648. eCollection 2025.
Hypertension development and progression are largely influenced by inflammation, which plays a critical role by activating the immune system and causing damage to the vascular endothelium. Metabolic dysfunction-associated fatty liver disease (MAFLD) is also associated with chronic low-grade inflammation, which drives disease progression via metabolic imbalances and adipose tissue dysfunction. This study investigates the relationship between inflammatory indices and MAFLD in hypertensive patients and assesses the predictive accuracy of these indices for MAFLD.
We performed a cross-sectional analysis involving 34,303 hypertensive patients from a Chinese hospital-based registry. The diagnosis of MAFLD was established using metabolic dysfunction criteria alongside evidence of hepatic steatosis confirmed through imaging. Complete blood counts were used to calculate inflammatory indices, including the monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory response index (SIRI), systemic immune-inflammation index (SII), and aggregate index of systemic inflammation (AISI). To assess the relationship between inflammatory indices and MAFLD, multivariable logistic regression was performed with adjustments for potential confounders. The diagnostic performance of these indices was analyzed using receiver operating characteristic (ROC) curves and area under the curve (AUC) calculations.
Patients with MAFLD exhibited significantly elevated levels of all inflammatory indices compared to those without. After multivariable adjustment, each standard deviation increase in AISI, SIRI, and SII was associated with a 74%, 62%, and 58% increased odds of MAFLD, respectively. The AUC for AISI was 0.659, indicating moderate diagnostic accuracy. The AUCs for SIRI and SII were 0.626 and 0.619, respectively, while NLR, PLR, and MLR had lower AUCs of 0.593, 0.558, and 0.589, respectively.
In hypertensive patients, inflammatory indices, especially AISI, show a strong association with MAFLD, indicating their potential utility in risk stratification within clinical settings. Further research is needed to evaluate the effectiveness of these markers in the management of MAFLD.
高血压的发生和发展在很大程度上受炎症影响，炎症通过激活免疫系统和损害血管内皮发挥关键作用。代谢功能障碍相关脂肪性肝病（MAFLD）也与慢性低度炎症相关，这种炎症通过代谢失衡和脂肪组织功能障碍推动疾病进展。本研究调查高血压患者炎症指标与MAFLD之间的关系，并评估这些指标对MAFLD的预测准确性。
我们对一家中国医院登记处的34303例高血压患者进行了横断面分析。MAFLD的诊断采用代谢功能障碍标准并结合影像学证实的肝脂肪变性证据。通过全血细胞计数计算炎症指标，包括单核细胞与淋巴细胞比值（MLR）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、全身炎症反应指数（SIRI）、全身免疫炎症指数（SII）和全身炎症聚集指数（AISI）。为了评估炎症指标与MAFLD之间的关系，进行了多变量逻辑回归分析，并对潜在混杂因素进行了调整。使用受试者工作特征（ROC）曲线和曲线下面积（AUC）计算分析这些指标的诊断性能。
与无MAFLD的患者相比，MAFLD患者的所有炎症指标水平均显著升高。多变量调整后，AISI、SIRI和SII每增加一个标准差，MAFLD的患病几率分别增加74%、62%和58%。AISI的AUC为0.659，表明诊断准确性中等。SIRI和SII的AUC分别为0.626和0.619，而NLR、PLR和MLR的AUC较低，分别为0.593、0.558和0.589。
在高血压患者中，炎症指标，尤其是AISI，与MAFLD密切相关，表明它们在临床环境中进行风险分层具有潜在效用。需要进一步研究来评估这些标志物在MAFLD管理中的有效性。
