Associations of C-reactive protein to lymphocyte ratio and metabolic-dysfunction-associated steatotic liver disease: evidence from NHANES 2017-2018

BMC Gastroenterol. 2024 Dec 24;24(1):475. doi: 10.1186/s12876-024-03458-7.

Abstract

Background: This study aimed to investigate the association between Metabolic-dysfunction-associated steatotic liver disease(MASLD)and C-reactive protein/lymphocyte ratio (CLR).

Methods: MASLD was defined as a Controlled Attenuation Parameter (CAP ≥ 274dB/m) and CLR = C-reactive protein/lymphocyte. A multifactor linear regression model was used to test the relationship between MASLD and CLR. Smoothed curves and threshold effects analyses were fitted to describe nonlinear relationships. Subgroup analyses and interaction tests were then performed according to gender, prevalence of diabetes, ethnicity, and smoking status.

Results: A total of 1846 participants from the NHANES database were included in this study. In the unadjusted model and model 1 (adjusted for age, sex, and race), CLR was positively associated with MASLD pathogenicity. Unadjusted model (OR = 1.04, 95% CI: 1.02-1.07, P = 0.0017), model 1 (OR = 1.04, 95% CI: 1.01-1.07, P = 0.0056). The results of the fitted smoothed curves showed that CLR and the risk of developing MASLD were nonlinear. Interaction tests and subgroup analyses confirmed that there were no significant interactions between CLR and MASLD causation with gender, race, prevalence of diabetes mellitus, and smoking status(P interaction>0.05).

Conclusions: This study shows that CLR is positively associated with the risk of developing MASLD Targeting CLR levels may be a new approach to treating MASLD.

Keywords: C-reactive protein to lymphocyte ratio; MASLD; NHANES.

MeSH terms

  • Adult
  • Aged
  • C-Reactive Protein* / analysis
  • C-Reactive Protein* / metabolism
  • Female
  • Humans
  • Lymphocyte Count
  • Lymphocytes
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / blood
  • Non-alcoholic Fatty Liver Disease / complications
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Nutrition Surveys*
  • Prevalence
  • Risk Factors

Substances

  • C-Reactive Protein