■本研究探讨了美国成年人群中预后营养指数(PNI)与非酒精性脂肪性肝病(NAFLD)和晚期肝纤维化(AF)发病率之间的潜在关联。
■从2017年至2020年的美国国家健康和营养检查调查(NHANES)下载了6409名≥18岁参与者的信息。多因素分析与人口学因素相结合,评估PNI、NAFLD,和AF。使用受限三次样条(RCS)来表征PNI与NAFLD和AF之间的非线性关联。
■没有NAFLD的患者在诸如年龄、淋巴细胞计数,中性粒细胞计数,中性粒细胞与淋巴细胞比率(NLR),血小板与淋巴细胞比率(PLR),全身免疫炎症指数(SII),总胆固醇,甘油三酯,HbA1c,天冬氨酸转氨酶(AST),丙氨酸转氨酶(ALT)高于NAFLD患者。有趣的是,与非NAFLD患者相比,非NAFLD患者的血清白蛋白水平显著升高.在没有AF的子集中,NLR的测量值明显较低,年龄,AST,ALT,γ-谷氨酰转移酶,甘油三酯,中性粒细胞计数,和体重指数(BMI)比房颤患者。很明显,与受AF影响的个体相比,没有AF的个体的平均白蛋白和PNI水平明显升高。在综合多变量框架中,在PNI和NAFLD之间观察到直接相关(调整后的比值比[aOR]=1.07,95%置信区间[CI]:1.05-1.09;p<0.001),而PNI和AF呈负相关(aOR=0.92;95%CI:0.88-0.96;p<0.001)。在RCS模型中,PNI和NAFLD之间的关系迅速上升,峰值约为52。相反,在PNI和AF之间观察到非线性负相关.
■我们的分析结果表明,PNI水平升高与NAFLD风险增加呈正相关,但与房颤风险成反比。为了对这些观察结果进行可靠的验证,需要进一步的研究。
UNASSIGNED: This study explored the potential association between the Prognostic Nutritional Index (PNI) and the incidence of non-alcoholic fatty liver disease (NAFLD) and advanced liver fibrosis (AF) in the adult population of the United States.
UNASSIGNED: Information on 6409 participants ≥18 years old was downloaded from the U.S. National Health and Nutrition Examination Survey (NHANES) from 2017 to 2020. Multivariate analysis was combined with demographic factors to assess the relationships between PNI, NAFLD, and AF. A restricted cubic spline (RCS) was used to characterise the nonlinear association between the PNI and NAFLD and AF.
UNASSIGNED: Patients without NAFLD had substantially lower mean values for parameters such as age, lymphocyte count, neutrophil count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammatory index (SII), total cholesterol, triglycerides, HbA1c, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) than patients with NAFLD. Interestingly, non-NAFLD patients showed a pronounced increase in serum albumin levels compared to their NAFLD counterparts. In the subset without AF, there were discernibly lower measures of NLR, age, AST, ALT, γ-glutamyl transferase, triglycerides, neutrophil count, and body mass index (BMI) than in patients with AF. It was evident that those without AF had markedly elevated mean albumin and PNI levels in comparison to AF-affected individuals. In the comprehensive multivariable framework, a direct correlation was observed between PNI and NAFLD (adjusted odds ratio[aOR] = 1.07, 95% confidence interval [CI]: 1.05-1.09; p < 0.001), whereas PNI and AF were inversely correlated (aOR = 0.92; 95% CI: 0.88-0.96; p < 0.001). Within the RCS model, a swift ascendancy was noted in the relationship between the PNI and NAFLD, peaking at approximately 52. Conversely, a non-linear inverse association was observed between PNI and AF.
UNASSIGNED: Our analytical results indicate that elevated PNI levels are positively associated with an increased risk of NAFLD, but inversely related to the risk of AF. For robust validation of these observations, further research is required.