Wang Yaqiong, Chen Kuangyang, Yu Jie, Tu Yifan, Zhao Yuxin, Zhang Yikai, Hu Yepeng, Yang Hong, Yan Han, Zheng Chao
Department of Endocrinology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang province, China.
Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine for Metabolic & Endocrine Diseases, Hangzhou, Zhejiang province, China.
BMC Gastroenterol. 2025 Jul 1;25(1):448. doi: 10.1186/s12876-025-04018-3.
Inflammation plays a key role in the onset of MASLD, progression to MASH, and is associated with poor prognosis of MASLD. The aim of this study was to thoroughly investigate the association of different systemic inflammatory indicators with all-cause mortality and CVD mortality outcome in MASLD.
Data were from the NHANES cohort. Mortality data were from the NDI. Systemic inflammatory indicators analyzed included lymphocytes, monocytes, neutrophils, platelets, CRP, MLR, NLR, and PLR. Associations of inflammatory indicators with mortality were analyzed using Kaplan-Meier curves, Cox regression, and restricted cubic spline analysis. Time-dependent ROC curve was performed to analysis the predictive value of inflammatory indicators for mortality.
10,308 MASLD adults were included. Systemic inflammatory markers were associated with mortality outcome in MASLD. Specifically, lymphocyte and platelet count showed an L-shaped association with all-cause mortality in MASLD patients, monocyte and neutrophil count and CRP level demonstrated a positive nonlinear correlation, NLR and MLR presented a linear positive correlation, and PLR presented a U-shaped association (all P < 0.001). Time-dependent ROC curve analysis showed that NLR and MLR exhibited higher predictive values among all these markers for mortality in MASLD adults.
Systemic inflammatory indicators were associated with mortality outcome in MASLD and may serve as valuable prognostic biomarkers for MASLD.
炎症在代谢功能障碍相关脂肪性肝病（MASLD）的发病、进展为代谢功能障碍相关脂肪性肝炎（MASH）过程中起关键作用，且与MASLD的不良预后相关。本研究的目的是全面调查不同全身炎症指标与MASLD全因死亡率和心血管疾病（CVD）死亡率结局之间的关联。
数据来自美国国家健康与营养检查调查（NHANES）队列。死亡率数据来自国家死亡索引（NDI）。分析的全身炎症指标包括淋巴细胞、单核细胞、中性粒细胞、血小板、C反应蛋白（CRP）、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）和血小板与淋巴细胞比值（PLR）。使用Kaplan-Meier曲线、Cox回归和限制性立方样条分析来分析炎症指标与死亡率之间的关联。采用时间依赖性受试者工作特征（ROC）曲线分析炎症指标对死亡率的预测价值。
纳入了10308名患有MASLD的成年人。全身炎症标志物与MASLD的死亡率结局相关。具体而言，淋巴细胞和血小板计数与MASLD患者的全因死亡率呈L形关联，单核细胞和中性粒细胞计数以及CRP水平呈正非线性相关，NLR和MLR呈线性正相关，PLR呈U形关联（所有P＜0.001）。时间依赖性ROC曲线分析表明，在所有这些标志物中，NLR和MLR对MASLD成年人的死亡率具有较高的预测价值。
全身炎症指标与MASLD的死亡率结局相关，可能作为MASLD有价值的预后生物标志物。
