Study On The Correlation Between Liver Inflammation And Neutrophil Lymphocyte Ratio In Non-alcoholic Fatty Liver Disease

ObjectiveNon-alcoholic fatty liver disease(NAFLD)is a worldwide medical problem.At present,there is a lack of research on the prevalence of NAFLD,analysis of risk factors and reliable non-invasive clinical indicators for the evaluation of liver inflammation in NAFLD except for pathology.This study intends to collect clinical baseline data of physical examiners,conduct statistical analysis on the prevalence and risk factors of NAFLD,and screen inflammatory indicators that may be related to NAFLD liver inflammation,and further verify the correlation between selected Neutrophil Lymphocyte Ratio(NLR)and liver inflammation in NAFLD in hospitalized NAFLD patients with pathological diagnosis.It will provide a reference for the noninvasive diagnosis and prediction of liver inflammation in NAFLD.Methods1.Select persons who have participated in the physical examination at Northern Jiangsu People’s Hospital from May to October 2020 and meet the inclusion criteria,and collect relevant data of the physical examiners through questionnaire survey,physical measurement,serum index detection and abdominal ultrasound examination,the overall prevalence of NAFLD and the prevalence of different ages,genders,and metabolic diseases were statistically analyzed.2.According to the NAFLD diagnostic criteria,the physical examiners were divided into NAFLD group and healthy control group,and the differences of indexes between the two groups were analyzed.Some indexes with statistically significant differences between the groups were included in the Logistic univariate correlation analysis.The statistically significant indexes were then included in the Logistic multivariate correlation analysis to obtain the risk factors for NAFLD.Analyze the correlation between the inflammatory indicators in the baseline data and alanine aminotransferase(ALT)of NAFLD patients to screen the indexes that may be related to liver inflammation in NAFLD in routine physical examination data.3.In order to further verify the correlation between the selected NLR and liver inflammation in NAFLD,we collected NAFLD patients with liver pathological diagnosis among hospitalized patients in Northern Jiangsu People’s Hospital and Nanjing Gulou Hospital from January 2020 to December 2020,and collected blood routine,biochemical and other related data.According to their liver pathology,they were divided into mild inflammation group and severe inflammation group.The correlation between NLR and liver inflammation in NAFLD was evaluated by comparison of indicators between groups,correlation analysis with inflammation grade,and ROC curve.Results1.A total of 2,614 patients were included in the study,and 840 NAFLD patients were detected with a prevalence rate of 32.1%.The prevalence rate was 47.2% for men and13.2% for women.The physical examiners were divided into 5 groups according to their ages: <30 years old,30-39 years old,40-49 years old,50-59 years old,and≥60 years old.The prevalence of each age group was 20.0%,29.8%,37.1%,37.8% and 38.9%,the difference in prevalence between men and women and the difference in prevalence between age groups were statistically significant(P<0.01).The prevalence of NAFLD in patients with diabetes,hypertension,hyperlipidemia,overweight,and obesity were 62.4%,54.0%,51.7%,50.1%,and 80.0%,which were higher than those in the healthy control groups,and the difference were statistically significant(P<0.01).2.Logistic correlation analysis showed that waist circumference,uric acid,triglycerides,and high-density lipoprotein were independently correlated with NAFLD(P<0.001),and the OR values were 1.076,1.003,1.378,and 0.311.Through the analysis of the correlation between inflammatory indicators and ALT,it was found that NLR and ALT showed a positive correlation.The Pearson correlation coefficient was 0.342 and the correlation was statistically significant(P<0.001).3.The average NLR of NAFLD with severe liver inflammation group was 4.87,and the average NLR of the mild inflammation group was 3.05,the difference between the groups was statistically significant(P<0.0001).Spearman analysis found that NLR was positively correlated with the degree of inflammation in NAFLD,with a correlation coefficient of0.413,which was statistically significant(P<0.001).The area under the ROC curve predicted by NLR for severe liver inflammation in NAFLD is 0.768,the cut-off value is4.315,the sensitivity is 71.73%,and the specificity is 78.86%.Conclusion1.The overall prevalence of NAFLD is relatively high,and it increases with age.The prevalence of men is higher than that of women.The prevalence of NAFLD in diabetes,hypertension,hyperlipidemia,obesity,and overweight is higher than the overall level.2.Increased waist circumference,high triglycerides,low high density lipoprotein,and high uric acid are risk factors for NAFLD.3.NLR is positively correlated with liver inflammation in NAFLD,and can be used as a clinical indicator to predict liver inflammation in NAFLD.