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

Abstract

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

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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