Li Hang, Chen Gaohui, Bao Shiting, Lin Guotai, Xie Fengwei, Tan Xiaoyu, Li Mingyi, Fang Shuo, Dai Wei
Department of Hepatobiliary Surgery, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.
Department of Radiology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.
Int J Surg. 2025 Apr 4. doi: 10.1097/JS9.0000000000002374.
The relationship between the Advanced Lung Cancer Inflammation Index (ALI) and all-cause mortality in patients with Metabolic Dysfunction-Associated Steatohepatitis and Metabolic-Associated Alcoholic Liver Disease and other combination etiology of steatosis (MASLD/MetALD & Mixed Etiology Steatosis) is not well-understood. Current evidence is insufficient to establish this association, yet it holds critical importance for healthcare and public health. Research into the link between ALI and all-cause mortality in MASLD/MetALD & Mixed Etiology Steatosis remains a topic of interest.
This study investigated the association between ALI and all-cause mortality in MASLD/MetALD & Mixed Etiology Steatosis patients, and explored the clinical significance of this association.
We conducted a cohort study using data from the National Health and Nutrition Examination Survey between 2007 and 2018, involving 4502 adult participants with MASLD/MetALD & Mixed Etiology Steatosis in the United States. Data collected included age, sex, race, education, marital status, poverty-to-income ratio, alanine aminotransferase levels, aspartate aminotransferase levels, high-density lipoprotein cholesterol, total cholesterol, diabetes mellitus, coronary heart disease, and stroke. Cox proportional hazards regression models were used to assess the relationship between ALI and all-cause mortality, with follow-up through 31 December 2019, from the National Center for Health Statistics.
The study found that ALI in patients was significantly negatively associated with the risk of all-cause mortality in U.S. adults with MASLD/MetALD & Mixed Etiology Steatosis. Participants with higher ALI levels had a significantly lower risk of all-cause mortality compared to those with lower ALI levels. After full adjustment, moderate ALI levels were associated with a 42% reduced risk (hazard ratio [HR]: 0.58, 95% confidence interval [CI]: 0.41-0.81), and high ALI levels were associated with a 49% reduced risk (HR: 0.51, 95% CI: 0.35-0.73) of all-cause mortality. No significant interactions were observed in subgroup analyses (P > 0.05).
This study suggested that high ALI levels are associated with a reduced risk of all-cause mortality in MASLD/MetALD & Mixed Etiology Steatosis patients. These findings may have important clinical implications for healthcare providers managing MASLD/MetALD & Mixed Etiology Steatosis patients, emphasizing the potential role of ALI as a prognostic marker for all-cause mortality.
晚期肺癌炎症指数（ALI）与代谢功能障碍相关脂肪性肝炎、代谢相关酒精性肝病以及其他脂肪变性合并病因（MASLD/MetALD及混合病因脂肪变性）患者的全因死亡率之间的关系尚未完全明确。目前的证据不足以证实这种关联，但它对医疗保健和公共卫生至关重要。对ALI与MASLD/MetALD及混合病因脂肪变性患者全因死亡率之间联系的研究仍是一个受关注的话题。
本研究调查了ALI与MASLD/MetALD及混合病因脂肪变性患者全因死亡率之间的关联，并探讨了这种关联的临床意义。
我们利用2007年至2018年美国国家健康与营养检查调查的数据进行了一项队列研究，纳入了4502名患有MASLD/MetALD及混合病因脂肪变性的成年参与者。收集的数据包括年龄、性别、种族、教育程度、婚姻状况、贫困收入比、丙氨酸转氨酶水平、天冬氨酸转氨酶水平、高密度脂蛋白胆固醇、总胆固醇、糖尿病、冠心病和中风。使用Cox比例风险回归模型评估ALI与全因死亡率之间的关系，并通过美国国家卫生统计中心随访至2019年12月31日。
研究发现，在美国患有MASLD/MetALD及混合病因脂肪变性的成年人中，患者的ALI与全因死亡风险显著负相关。与ALI水平较低的参与者相比，ALI水平较高的参与者全因死亡风险显著更低。在进行全面调整后，中等ALI水平与全因死亡风险降低42%相关（风险比[HR]：0.58，95%置信区间[CI]：0.41 - 0.81），高ALI水平与全因死亡风险降低49%相关（HR：0.51，95%CI：0.35 - 0.73）。亚组分析未观察到显著的相互作用（P > 0.05）。
本研究表明，高ALI水平与MASLD/MetALD及混合病因脂肪变性患者全因死亡风险降低相关。这些发现可能对管理MASLD/MetALD及混合病因脂肪变性患者的医疗保健提供者具有重要的临床意义，强调了ALI作为全因死亡率预后标志物 的潜在作用。
