Diagnostic Value of Neutrophil to Lymphocyte Ratio in Non-Alcoholic Fatty Liver Disease Evaluated Using Transient Elastography (TE) with Controlled Attenuated Parameter (CAP)

Figures & data

Table 1 Basic Characteristics of Research Subjects

Variable	Total (N=106)
Gender
Male (%)	40 (37.7)
Female (%)	66 (62.3)
Age, mean in years (SD)	57.29 (11.1)
<50 years	24 (22.6)
≥ 50 years	82 (77.4)
BMI, mean in kg/m^2 (SD)	28.7 (4.38)
BMI ≥ 25 (%)	89 (84)
BMI < 25 (%)	17 (16)
Central obesity
Yes (%)	88 (83)
No (%)	18 (17)
High level of blood pressure
Yes (%)	73 (68.9)
No (%)	33 (31.1)
Diabetes Mellitus
Yes (%)	81 (76.4)
No (%)	25 (23.6)
Fasting blood glucose, median in mg/dl (min-max)	119 (41–348)
Triglyceride, median in mg/dl (min-max)	143 (19–448)
High (%)	54 (50.9)
Normal (%)	52 (49.1)
HDL, median in mg/dl (min-max)	43.5 (19–116)
Low (%)	59 (55.7)
Normal (%)	47 (44.3)
Metabolic syndrome
Yes (%)	82 (77.4)
No (%)	24 (22.6)
Aspartate aminotransferase (AST), median in u/l (min-max)	20 (12–144)
Alanine aminotransferase (ALT), median in u/l (min-max)	21(6–204)
CAP, mean in dB/m (SB)	283.37 (42.2)
Mild steatosis (%)	36 (34)
Moderate-severe steatosis (%)	70 (66)
Fibroscan^®, median kPa (min-max)	6.14 (2.8–18.2)
Non-significant fibrosis (%)	26 (24.5)
Significant fibrosis (%)	80 (75.5)
Drugs (%)
Statin	86 (81.1)
Anti-hypertension	71 (67)
Anti-diabetic drugs (GLP-1 agonist or SGLT2-inhibitor)	0 (0)
Leukocytes, mean in cell/mm^3 (SD)	7812.9 (1782.4)
Absolute neutrophil count, mean in cell/mm^3 (SD)	4559.6 (1229.9)
Absolute lymphocyte count, mean in cell/mm^3 (SD)	2433.7 (671.2)
NLR, mean (SD)	1.96 (0.58)

Table 2 Pearson Correlation Test Between CAP and NLR

Variable	Mean (SD)	r	p
CAP	283.4 (42.2)	0.648	<0.001
NLR	1.96 (0.58)

Abbreviations: CAP, controlled attenuation parameter; NLR, neutrophil to lymphocyte count ratio.

Table 3 Spearman Correlation Test Between TE and NLR

Variable	Mean (SD)/Median (Min-Max)	r	p
TE	6.14 (2.8–18.2)	0.621	<0.001
NLR	1.96 (0.58)

Abbreviations: CAP, controlled attenuation parameter; NLR, neutrophil to lymphocyte count ratio.

Table 4 Multivariate Analysis of NLR and CAP Linear Regression

	Variables	Coefficient	Correlation Coefficient	P value
Step 1	NLR	45.719	0.626	<0.001
	Metabolic syndrome	7.842	0.078	0.302
	Diabetes mellitus	5.235	0.053	0.504
	Constant	183.78		<0.001
Step 2	NLR	47.329	0.648	<0.001
	Constant	190.693		<0.001

Abbreviation: NLR, neutrophil to lymphocyte count Ratio.

Table 5 Multivariate Analysis of NLR and TE Linear Regression

	Variables	Coefficient	Correlation Coefficient	P value
Step 1	NLR	2.586	0.399	<0.001
	Metabolic syndrome	0.366	0.057	0.488
	Diabetes mellitus	0.122	0.019	0.823
	Constant	0.696		0.421
Step 2	NLR	2.634	0.565	<0.001
	Constant	0.979		0.207

Abbreviation: NLR, neutrophil to lymphocyte count ratio.

Figure 1 NLR ROC curve for hepatic steatosis prediction.

Figure 2 NLR ROC curve for hepatic fibrosis prediction.

Table 6 Comparison of 2 Mean Analysis of NLR Values for the Degree of Steatosis

Steatosis Degree	N	Mean NLR	Standard Deviation	p value
Mild	36	1.492	0.305	p<0.001
Moderate-severe	70	2.198	0.538	p<0.001

Abbreviation: NLR, neutrophil to lymphocyte count Ratio.

Table 7 Comparison of 2 Mean Analysis of NLR Values for the Degree of Fibrosis

Fibrosis Degree	N	Mean NLR	Standard Deviation	p value
Non-significant	80	1.744	0.415	p<0.001
Significant	26	2.617	0.51	p<0.001