NLR对NAFLD患者预后预测价值的Meta分析

肝脏 ›› 2025, Vol. 30 ›› Issue (6): 813-819.

NLR对NAFLD患者预后预测价值的Meta分析

俞媛, 张丹丹, 包薇萍, 褚晓秋, 窦英磊, 张美云

211100 江苏南京市江宁中医院/中国药科大学附属江宁中医院脾胃病科(俞媛,张丹丹,窦英磊,张美云);南京中医药大学附属中西医结合医院内分泌科(包薇萍,褚晓秋)

收稿日期:2025-01-10 出版日期:2025-06-30 发布日期:2025-08-08
通讯作者: 张美云,Email:jnzyyzmy@126.com
基金资助:
江苏省中医药科技发展计划项目(MS2023064,MS2023036,MS2022029);江苏省中医药学会科研项目(XYLD2024001)

Prognostic role of neutrophil to lymphocyte ratio in nonalcoholic fatty liver disease: a Meta-analysis

YU Yuan¹, ZHANG Dan-dan¹, BAO Wei-ping², CHU Xiao-qiu², DOU Ying-lei¹, ZHANG Mei-yun¹

1. Department of Spleen and Stomach Diseases, Jiangning Traditional Chinese Medicine Hospital Affiliated to China Pharmaceutical University/Nanjing Jiangning Hospital of Traditional Chinese Medicine, Nanjing 211100, China;
2. Department of Endocrinology, Affiliated Hospital of Integrated of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210008, China

Received:2025-01-10 Online:2025-06-30 Published:2025-08-08
Contact: ZHANG Mei-yun, Email: jnzyyzmy@126.com

摘要/Abstract

摘要： 目的系统评价中性粒细胞/淋巴细胞(NLR)与非酒精性脂肪性肝病(NAFLD)预后之间的相关性。方法检索PubMed、Web of Science、中国知网、万方数据知识服务平台中有关NLR与NAFLD预后的相关性研究,检索时限为建库至2023年12月。2名研究者独立筛选文献、提取数据,并进行质量评价。采用Stata 15.0软件进行Meta分析。结果共纳入11篇文献,包括6项前瞻性研究、5项回顾性研究,共2044例NAFLD患者。Meta分析结果显示,出现非酒精性脂肪性肝炎(NASH)患者的NLR水平高于未出现NASH的患者(SMD=0.82,95%CI 0.33～1.30,P<0.001),NLR诊断灵敏度为0.77(95%CI 0.70～0.83),诊断特异度为0.65(95%CI 0.53～0.76),ROC曲线下面积(AUC)为0.79(95%CI 0.75～0.83);出现肝纤维化患者的NLR水平高于未出现肝纤维化的患者(SMD=1.17,95%CI 0.51～1.83,P<0.001),NLR诊断灵敏度为0.80(95%CI 0.70～0.87),诊断特异度为0.77(95%CI 0.65～0.86),AUC为0.85(95%CI 0.82～0.88)。敏感性分析结果表明,研究结果稳定可靠。Egger检查显示,NLR对NASH诊断未发现发表偏倚(P=0.823),对纤维化诊断存在发表偏倚(P=0.004)。结论 NLR可作为预测NAFLD患者NASH和肝纤维化的新指标。

关键词: 非酒精性脂肪性肝病, 中性粒细胞与淋巴细胞比值, 预后, Meta分析

Abstract: Objective To systematically evaluate the correlation between neutrophil to lymphocyte ratio (NLR) and the prognosis of nonalcoholic fatty liver disease (NAFLD). Methods Studies about the correlation between NLR and the prognosis of NAFLD were searched in PubMed, Web of Science, China National Knowledge Infrastructure, and Wanfang Data Knowledge Service Platform from the establishment of the database to December 2023. Two researchers independently screened the literature, extracted data, and performed quality assessment. Meta-analysis was performed using Stata software (Version 15.0). Results A total of 11 articles were included, including 6 prospective studies and 5 retrospective studies, with a total of 2,044 NAFLD patients. The results of meta-analysis showed that the NLR level of patients with NASH was higher than that of patients without NASH (SMD=0.82, 95%CI 0.33-1.30, P<0.001), the diagnostic sensitivity of NLR was 0.77 (95%CI 0.70-0.83), the diagnostic specificity was 0.65 (95%CI 0.53-0.76), and the area under the receiver operating characteristic curve (AUC) was 0.79 (95%CI 0.75-0.83); the NLR level of patients with fibrosis was higher than that of patients without fibrosis (SMD=1.17, 95%CI 0.51-1.83, P<0.001), the diagnostic sensitivity of NLR was 0.80 (95%CI 0.70-0.87), the diagnostic specificity was 0.77 (95%CI 0.65-0.86), and the AUC was 0.85 (95%CI 0.82-0.88). The results of sensitivity analysis showed that the research results were stable and reliable. Egger test showed that there was no publication bias in the diagnosis of NASH by NLR (P=0.823), and there was a publication bias in the diagnosis of fibrosis (P=0.004). Conclusion NLR can be used as a new indicator for predicting NASH and liver fibrosis in patients with NAFLD.

Key words: Non-alcoholic fatty liver disease, Neutrophil-to-lymphocyte ratio, Prognosis, Meta-analysis

俞媛, 张丹丹, 包薇萍, 褚晓秋, 窦英磊, 张美云. NLR对NAFLD患者预后预测价值的Meta分析[J]. 肝脏, 2025, 30(6): 813-819.

YU Yuan, ZHANG Dan-dan, BAO Wei-ping, CHU Xiao-qiu, DOU Ying-lei, ZHANG Mei-yun. Prognostic role of neutrophil to lymphocyte ratio in nonalcoholic fatty liver disease: a Meta-analysis[J]. Chinese Hepatolgy, 2025, 30(6): 813-819.

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