Correlation Between PLR,LMR And Hepatic Fibrosis In Metabolically Related Fatty Liver Disease

objective:The objective of this study was to assess the association of platelet to lymphocyte ratio(PLR)and lymphocyte to monocyte ratio(LMR)with the severity of hepatic fibrosis in metabolic associated fatty liver disease(MAFLD).Methods: A total of 96 cases diagnosed with MAFLD in the First Affiliated Hospital of Nanchang University from April 1,2015 to September 30,2022 were retrospectively collected,and 89 healthy people in the physical examination center were also collected as the control group.A total of 185 cases were included in this study.PLR and LMR were calculated by lymphocyte count,monocyte count and platelet count in blood routine.First,the differences in general clinical data between the non-MAf LD group and the MAFLD group were compared,and then the severity of liver fibrosis in the MAFLD group was graded using NFS score(non-alcoholic fatty liver fibrosis score).NFS≤-1.455 was defined as non-advanced liver fibrosis,and NFS≥0.676 was defined as advanced liver fibrosis.The difference of general clinical data between the non-advanced hepatic fibrosis group(n=61)and the advanced hepatic fibrosis group(n=35)was compared,and the correlation between PLR,LMR and the severity of MAFLD hepatic fibrosis was analyzed.The predictive effect of PLR and LMR on liver fibrosis in MAFLD was analyzed by receiver operating characteristic(ROC)curve.Results:1.Compared between the MAFLD group and the non-MAf LD group,in terms of demographic parameters,patients with MAFLD were older than those without MAFLD,and the proportion of men with MAFLD was greater than that of women.In terms of anthropometric parameters,blood pressure and BMI were higher in the MAFLD group.In terms of hematological parameters,MAFLD group MNC,ALT,AST,γ-The levels of ggt,ALP,FBG,and TG were significantly higher in the non MAFLD group,while TC,ALB,HDL-c,PLR and LMR in MAFLD group were significantly lower than those in non-MAf LD group(P<0.05).There were no significant differences in PLT,LYM,TB,DBil and LDL-c between the two groups(P>0.05).2.There was no statistical significance in gender,BMI,smoking history,systolic blood pressure,MNC,AST,TB,DBil,gamma-ggt,ALP,TC,HDL-c between the non-advanced liver fibrosis group and the advanced liver fibrosis group(P>0.05).There were significant differences in age,diastolic blood pressure,PLT,LYM,ALT,ALB,FBG,TG and LDL-c between the two groups(P<0.05).The PLR and LMR of advanced hepatic fibrosis group were significantly lower than those of non-advanced hepatic fibrosis group,and the difference was statistically significant(P<0.05).3.After adjusting for confounding factors,PLR and LMR were independent influencing factors of liver fibrosis in MAFLD.The odds ratios were 0.914(95%CI :0.846-0.989)and 0.148(95%CI :0.023-0.935),respectively,indicating that the lower the PLR and LMR,the greater the likelihood of severe liver fibrosis.4.In Spearman correlation analysis,PLR,LMR were negatively correlated with NFS(rs=-0.447,P <0.001;rs =-0.221,P = 0.03),so PLR and LMR were negatively correlated with the severity of hepatic fibrosis.5.The ROC curve analysis results show that the areas under the ROC curves of PLR and LMR are 0.735 and 0.724,respectively,with 95% confidence intervals of0.634-0.837 and 0.623-0.826,respectively.The P-values are both less than 0.001.The best truncation value of PLR was 94.13912,sensitivity was 0.803,specificity was0.543,and the best truncation value of LMR was 4.441156,sensitivity was 0.574,specificity was 0.829.Conclusion:PLR and LMR have good predictive effect on liver fibrosis in MAFLD.PLR and LMR were negatively correlated with the severity of liver fibrosis in MAFLD.PLR and LMR are readily available markers of inflammation,which are correlated with the severity of fibrosis.This simple diagnostic method could be widely used in the future.