Zhang Meng, Yuan Yuan, Wang Chenglong, Huang You, Fan Mingli, Li Xiangling, Qin Zujie
Guangxi International Zhuang Medicine Hospital (Affiliated International Zhuang Medicine Hospital, Guangxi University of Chinese Medicine), Nanning, 530200, China.
School of Public Health and Management, Guangxi University of Chinese Medicine, Nanning, 530200, China.
BMC Gastroenterol. 2025 May 23;25(1):399. doi: 10.1186/s12876-025-03998-6.
Fatty liver disease (FLD), characterized by hepatic lipid accumulation, impairs quality of life and can progress to cirrhosis and hepatocellular carcinoma, imposing a healthcare burden. This study investigates the association between the aggregate index of systemic inflammation (AISI) and FLD prevalence, evaluating AISI's potential as an early biomarker for risk assessment.
Data were obtained from the National Health and Nutrition Examination Survey (NHANES) database, which encompasses the years 2017 through 2020. Participants were chosen based on the availability of controlled attenuation parameter (CAP) scores derived from transient elastography (TE), a technique utilized for assessing liver steatosis. The formula employed to compute the AISI is as follows: AISI = N × P × M / L, where N, P, M, and L refer to neutrophils, platelets, monocytes, and lymphocytes, respectively. Additionally, demographic, socioeconomic, dietary, and health-related information was gathered. Logistic regression models were utilized to pinpoint risk factors associated with FLD, and a nomogram was created to forecast FLD risk.
Of the 3,961 participants, 2,377 (60.0%) were diagnosed with FLD based on a CAP score ≥ 248 dB/m. Elevated AISI was significantly associated with FLD (P = 0.021). Other significant risk factors included sex, age, BMI, race, marital status, hypertension, and diabetes. The nomogram demonstrated excellent discriminatory performance with an AUC of 0.814 (95% CI: 0.800, 0.827) and good calibration.
This study reveals a significant, independent association between elevated AISI and increased FLD risk in the U.S. population, even after adjusting for confounders. AISI demonstrated good discriminative performance for FLD, but its effect size suggests it should supplement, not replace, existing clinical risk assessment tools. AISI, a cost-effective biomarker, holds potential for enhancing FLD screening, particularly in resource-limited settings.
脂肪性肝病（FLD）以肝脏脂质蓄积为特征，会损害生活质量，并可能进展为肝硬化和肝细胞癌，带来医疗负担。本研究调查全身炎症综合指数（AISI）与FLD患病率之间的关联，评估AISI作为风险评估早期生物标志物的潜力。
数据来自国家健康与营养检查调查（NHANES）数据库，涵盖2017年至2020年。根据通过瞬时弹性成像（TE）获得的控制衰减参数（CAP）分数来选择参与者，TE是一种用于评估肝脏脂肪变性的技术。计算AISI的公式如下：AISI = N × P × M / L，其中N、P、M和L分别指中性粒细胞、血小板、单核细胞和淋巴细胞。此外，还收集了人口统计学、社会经济、饮食和健康相关信息。采用逻辑回归模型确定与FLD相关的风险因素，并创建列线图来预测FLD风险。
在3961名参与者中，2377名（60.0%）基于CAP分数≥248 dB/m被诊断为FLD。AISI升高与FLD显著相关（P = 0.021）。其他显著风险因素包括性别、年龄、体重指数、种族、婚姻状况、高血压和糖尿病。列线图显示出出色的鉴别性能，AUC为0.814（95%CI：0.800，0.827），校准良好。
本研究表明，在美国人群中，即使在调整混杂因素后，AISI升高与FLD风险增加之间也存在显著的独立关联。AISI对FLD表现出良好的鉴别性能，但其效应大小表明它应补充而非取代现有的临床风险评估工具。AISI作为一种具有成本效益的生物标志物，在加强FLD筛查方面具有潜力，尤其是在资源有限的环境中。
