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Abstract：
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a growing health crisis in the general population of the United States (U.S.), but the relationship between systemic immune-inflammation (SII) index and NAFLD is not known.
METHODS: We collected data from the National Health and Nutrition Examination Survey 2017-2018. Next, propensity score matching (PSM), collinearity analysis, restricted cubic spline (RCS) plot, logistic regression, quantile regression analysis, subgroup analysis, mediation analysis, and population attributable fraction were used to explore the association of the SII with risk of NAFLD.
RESULTS: A total of 665 participants including the 532 Non-NAFLD and 133 NAFLD were enrolled for further analysis after PSM analysis. The RCS results indicated that there was a linear relationship between the SII and controlled attenuation parameter (p for nonlinear = 0.468), the relationship also existed after adjustment for covariates (p for nonlinear = 0.769). The logistic regression results indicated that a high SII level was an independent risk factor for NAFLD (OR = 3.505, 95% CI: 1.092-11.249, P < 0.05). The quantile regression indicated that at higher quantiles (0.90, and 0.95) the SII was significantly associated with NAFLD (p < 0.05). Mediation analysis indicated that alanine aminotransferase (ALT), triglycerides, and blood urea nitrogen (BUN) were partially contribute to the relationship between SII and NAFLD. The population attributable fractions indicated that 23.19% (95% CI: 8.22%, 38.17%) of NAFLD cases could be attributed to SII corresponding to 133 NAFLD cases.
CONCLUSIONS: There was a positive linear relationship between the SII and the risk of NAFLD. The ALT, triglycerides, and BUN had a partial mediating effect on the relationship between the SII and NAFLD.
METHODS: We collected data from the National Health and Nutrition Examination Survey 2017-2018. Next, propensity score matching (PSM), collinearity analysis, restricted cubic spline (RCS) plot, logistic regression, quantile regression analysis, subgroup analysis, mediation analysis, and population attributable fraction were used to explore the association of the SII with risk of NAFLD.
RESULTS: A total of 665 participants including the 532 Non-NAFLD and 133 NAFLD were enrolled for further analysis after PSM analysis. The RCS results indicated that there was a linear relationship between the SII and controlled attenuation parameter (p for nonlinear = 0.468), the relationship also existed after adjustment for covariates (p for nonlinear = 0.769). The logistic regression results indicated that a high SII level was an independent risk factor for NAFLD (OR = 3.505, 95% CI: 1.092-11.249, P < 0.05). The quantile regression indicated that at higher quantiles (0.90, and 0.95) the SII was significantly associated with NAFLD (p < 0.05). Mediation analysis indicated that alanine aminotransferase (ALT), triglycerides, and blood urea nitrogen (BUN) were partially contribute to the relationship between SII and NAFLD. The population attributable fractions indicated that 23.19% (95% CI: 8.22%, 38.17%) of NAFLD cases could be attributed to SII corresponding to 133 NAFLD cases.
CONCLUSIONS: There was a positive linear relationship between the SII and the risk of NAFLD. The ALT, triglycerides, and BUN had a partial mediating effect on the relationship between the SII and NAFLD.
摘要：
背景：非酒精性脂肪性肝病（NAFLD）是美国（U.S.）普通人群中日益严重的健康危机，但全身免疫炎症（SII）指数与NAFLD之间的关系尚不清楚。
方法：我们收集了2017-2018年全国健康和营养检查调查的数据。接下来,倾向得分匹配(PSM)，共线性分析，限制三次样条(RCS)图,逻辑回归，分位数回归分析，亚组分析，调解分析,和人群归因分数用于探索SII与NAFLD风险的关联。
结果：共有665名参与者，包括532名非NAFLD和133名NAFLD纳入PSM分析后进行进一步分析。RCS结果表明，SII和受控衰减参数之间存在线性关系（非线性的p=0.468），在调整协变量后，这种关系也存在(非线性的p=0.769)。Logistic回归分析结果显示，高SII水平是NAFLD的独立危险因素（OR=3.505，95%CI：1.092～11.249，P<0.05）。分位数回归表明，在较高的分位数（0.90和0.95），SII与NAFLD显着相关（p<0.05）。中介分析表明丙氨酸转氨酶（ALT），甘油三酯，血尿素氮（BUN）部分参与了SII与NAFLD的关系。人口归因分数表明23.19%(95%CI：8.22%，38.17%)的NAFLD病例可归因于SII，相当于133例NAFLD病例。
结论：SII与NAFLD风险呈正线性关系。ALT,甘油三酯，BUN对SII与NAFLD之间的关系具有部分中介作用。
方法：我们收集了2017-2018年全国健康和营养检查调查的数据。接下来,倾向得分匹配(PSM)，共线性分析，限制三次样条(RCS)图,逻辑回归，分位数回归分析，亚组分析，调解分析,和人群归因分数用于探索SII与NAFLD风险的关联。
结果：共有665名参与者，包括532名非NAFLD和133名NAFLD纳入PSM分析后进行进一步分析。RCS结果表明，SII和受控衰减参数之间存在线性关系（非线性的p=0.468），在调整协变量后，这种关系也存在(非线性的p=0.769)。Logistic回归分析结果显示，高SII水平是NAFLD的独立危险因素（OR=3.505，95%CI：1.092～11.249，P<0.05）。分位数回归表明，在较高的分位数（0.90和0.95），SII与NAFLD显着相关（p<0.05）。中介分析表明丙氨酸转氨酶（ALT），甘油三酯，血尿素氮（BUN）部分参与了SII与NAFLD的关系。人口归因分数表明23.19%(95%CI：8.22%，38.17%)的NAFLD病例可归因于SII，相当于133例NAFLD病例。
结论：SII与NAFLD风险呈正线性关系。ALT,甘油三酯，BUN对SII与NAFLD之间的关系具有部分中介作用。
