Correlation Between NLR、PLR And Coronary Heart Disease In Patients With Non-alcoholic Fatty Liver Disease

Backround:Nonalcoholic fatty liver disease(NAFLD)is a chronic liver disease,which is increasingly common in clinical practice.In recent years,more and more studies have shown that NAFLD can be an independent risk factor for coronary heart disease.Inflammation plays an important role in the occurrence and development of NAFLD and coronary heart disease.Neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)are two new types of comprehensive inflammatory markers,and both can more stably reflect the body’s degree of inflammation.Previous studies have shown that there is a close correlation between NLR,PLR and NAFLD or coronary heart disease,and most of them are studies of individual indicators.However the current research on the relationship and correlation between NLR,PLR and coronary heart disease in NAFLD patients is rarely mentioned in domestic and foreign reports.Objective:This study aims to explore the correlation between NLR and PLR levels and NAFLD with coronary heart disease,and understand the predictive value of NLR and PLR in NAFLD patients with coronary heart disease and its severity.Methods:A retrospective collection of 290 inpatients who underwent coronary angiography and perfected abdominal color Doppler ultrasound in the Department of Cardiology of First Affiliated Hospital of Dalian Medical University from January 2020 to October 2020.Collect and record the general information and laboratory examination data of the research subjects after admission,and calculate the NLR,PLR and coronary Gensini scores.According to the results of coronary angiography and abdominal color Doppler ultrasound,the study subjects were divided into group A(no NAFLD and no coronary heart disease,n=40),group B(NAFLD without coronary heart disease,n=50),and group C(NAFLD combined with coronary heart disease,n=200),and analyze the relationship between NLR,PLR and other indicators and NAFLD complicated by coronary heart disease;According to the coronary Gensini score,group C was divided into three subgroups: C1 group(mild stenosis,Gensini score <20 points,n=53),C2group(moderate stenosis,20 points ≤Gensini score <50 points,n=81),and C3 group(severe stenosis,Gensini score ≥50 points,n=66),to analyze the relationship between NLR,PLR and other indicators and the severity of coronary artery disease in NAFLD patients with coronary heart disease.The data was analyzed statistically using SPSS26.0 software.Results:1.The NLR of group C was higher than that of group A and B [2.64(1.47)vs1.79(0.97)、1.96(1)],the PLR of group C was higher than group A [120.07(48.2)vs106.39(38.33)],the difference between the above groups was statistically significant(P<0.05),and there was no significant difference in NLR and PLR between group B and group A(P>0.05).2.Logistic regression analysis suggests that NLR is an independent risk factor for NAFLD complicated by coronary heart disease(OR=1.805,95%CI:1.184-2.750,P<0.01).3.ROC curve analysis shows that the area under the curve is 0.700(95%CI:0.625-0.775,P<0.001,NLR has a certain diagnostic value for NAFLD with coronary heart disease,and the best cut-off point is 2.4 with a sensitivity of 61% and a specificity of 72%.4.The NLR and PLR of the C3 group were higher than those of the C1 and C2 groups [NLR 2.95(2.29)vs 2.22(1.16)、2.58(1.23),PLR 131.46(53.27)vs 110.18(45.82)、117.49(50.90)],(P<0.05);However,there was no significant difference in NLR and PLR between C1 and C2 groups(P>0.05).5.Spearman correlation analysis showed that NLR,PLR and Gensini scores of NAFLD patients with coronary heart disease were positively correlated(respectively:R=0.323,P=0.000;R=0.210,P=0.003).Conclusion:1.In NAFLD patients,NLR is correlated with coronary heart disease and is an independent risk factor for NAFLD with coronary heart disease.When NLR>2.4,it indicates that it may be associated with coronary heart disease.2.NLR and PLR are positively correlated with the severity of coronary artery disease,so they may be used as a simple and effective auxiliary assessment method for coronary heart disease risk stratification.