Xi Jianxin, Wang Shengnan, Chen Jie, Law Jason Chi Shing, Fan Zhongqi, Lv Guoyue
Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun, Jilin, China.
China-Singapore Belt and Road Joint Laboratory on Liver Disease Research, Changchun, Jilin, China.
BMC Gastroenterol. 2025 May 1;25(1):327. doi: 10.1186/s12876-025-03924-w.
Non-alcoholic fatty liver disease (NAFLD) is recognized as the predominant chronic liver disorder globally. Inflammation is integral to the onset and progression of NAFLD. The C-reactive protein to lymphocyte ratio (CLR), a novel inflammatory marker, has yet to be explored in the context of NAFLD.
This investigation encompassed 4371 individuals from the National Health and Nutrition Examination Survey (NHANES) conducted between 2015-2018. Weighted logistic regression was employed to examine the correlation between CLR and NAFLD. Weighted Cox proportional hazards models were utilized to evaluate the association between CLR and all-cause and Cardiovascular disease (CVD) mortality in patients with NAFLD. Restricted cubic spline (RCS) curves were employed to assess the dose-response relationship. Threshold effect analysis was used to determine the existence of an inflection point.
After adjusting for all included covariates in Model 3, a positive correlation between lnCLR and NAFLD was identified (OR = 1.45, 95% CI = 1.16-1.81, P = 0.010). However, no significant association was observed between it and all-cause as well as CVD mortality among patients with NAFLD. The RCS curve illustrated a nonlinear association between CLR and NAFLD (P-nonlinear < 0.0001). Threshold effect analysis determined that the inflection point occurs at CLR = 1.667.
CLR exhibited a nonlinear positive association with NAFLD. Higher CLR levels may increase the risk of NAFLD. However, CLR does not affect all-cause and CVD mortality in patients with NAFLD.
非酒精性脂肪性肝病（NAFLD）被认为是全球主要的慢性肝脏疾病。炎症是NAFLD发病和进展的重要组成部分。C反应蛋白与淋巴细胞比值（CLR）作为一种新型炎症标志物，在NAFLD背景下尚未得到研究。
本研究纳入了2015 - 2018年进行的美国国家健康与营养检查调查（NHANES）中的4371名个体。采用加权逻辑回归分析CLR与NAFLD之间的相关性。使用加权Cox比例风险模型评估CLR与NAFLD患者全因死亡率和心血管疾病（CVD）死亡率之间的关联。采用限制立方样条（RCS）曲线评估剂量反应关系。采用阈值效应分析确定拐点的存在。
在模型3中对所有纳入的协变量进行调整后，发现lnCLR与NAFLD之间存在正相关（OR = 1.45，95%CI = 1.16 - 1.81，P = 0.010）。然而，在NAFLD患者中，未观察到CLR与全因死亡率以及CVD死亡率之间存在显著关联。RCS曲线显示CLR与NAFLD之间存在非线性关联（P - 非线性<0.0001）。阈值效应分析确定拐点出现在CLR = 1.667处。
CLR与NAFLD呈非线性正相关。较高的CLR水平可能会增加患NAFLD的风险。然而，CLR并不影响NAFLD患者的全因死亡率和CVD死亡率。
