Neutrophil-lymphocyte ratio (NLR) could be better predictor than C-reactive protein (CRP) for liver fibrosis in non-alcoholic steatohepatitis(NASH)


Yilmaz H., YALÇIN K. S. , Namuslu M., Celik H. T. , Sozen M., Inan O., ...More

Annals of Clinical and Laboratory Science, vol.45, no.3, pp.278-286, 2015 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 45 Issue: 3
  • Publication Date: 2015
  • Title of Journal : Annals of Clinical and Laboratory Science
  • Page Numbers: pp.278-286
  • Keywords: Neutrophil-Lymphocyte Ratio, NASH, Inflammation, Fibrosis, Liver pathology, 11-BETA-HYDROXYSTEROID DEHYDROGENASE TYPE-1, DISEASE, INFLAMMATION, SEVERITY, STEATOSIS, FAT, OVEREXPRESSION, SURVIVAL, OUTCOMES, MARKER

Abstract

© 2015 by the Association of Clinical Scientists, Inc.Background-Aim. Non-alcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease worldwide. The aims of this study were to assess Neutrophil-Lymphocyte Ratio (NLR) and C-reactive protein (CRP), and their association with liver histology in patients with non-alcoholic steatohepatitis (NASH), chronic hepatitis B (HBV), and hepatitis C (HCV). Material-Methods. We studied 38 consecutive patients with biopsy-proven NASH, 19 patients with HCV, 45 patients with HBV, and 35 healthy controls who were similar for age and gender. The stage of fibrosis was measured using a 6-point scale. Results. NLR was significantly higher in NASH patients compared to controls, HBV, and HCV patients (p<0.001, p<0.001, and p<0.001, respectively). NLR was positively associated with NAFLD activity scores (r=0.861, p<0.001). NLR was associated with hepatocyte ballooning degeneration (r=0.426, p=0.024), lobular inflammation(r=0.694, p<0.001), steatosis(r=0.498, p=0.007), and fibrosis stage(r=0.892, p<0.001) in NASH patients. Univariate and multivariate analyses showed that NLR was significantly associated with liver fibrosis and NAS (β=0.631, p<0.001 for liver fibrosis; β=0.753, p<0.001 for NAS in the multivariate model); however, CRP had no association with liver fibrosis and NAS. Conclusion. NLR is a promising and inexpensive inflammation marker that correlates with histological grade and fibrosis stage in NASH patients.