The role of C-reactive protein to lymphocyte ratio in NAFLD and mortality among NAFLD patients.

BACKGROUND

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.

METHOD

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.

RESULT

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.

CONCLUSION

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.