Predictive value of neutrophiltolymphocyte ratio in the severity of non-alcoholic fatty liver disease among type 2 diabetes patients


Kahraman N. K. , Kahraman C., Kocak F. E. , Cosgun S. , Sanal B., Korkmaz M., ...More

Acta Gastro-Enterologica Belgica, vol.79, no.3, pp.295-300, 2016 (Refereed Journals of Other Institutions) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 79 Issue: 3
  • Publication Date: 2016
  • Title of Journal : Acta Gastro-Enterologica Belgica
  • Page Numbers: pp.295-300
  • Keywords: diabetes mellitus, inflammation, Non-Alcoholic Fatty Liver Disease, steatosis, NEUTROPHIL-LYMPHOCYTE RATIO, LOW-GRADE INFLAMMATION, NECROSIS-FACTOR-ALPHA, RISK, FIBROSIS, STEATOHEPATITIS, INTERLEUKIN-6, PATHOGENESIS, PREVALENCE, MORTALITY

Abstract

© 2016, Universa Press. All rights reserved.Background: Non-alcoholic fatty liver disease is a progressive inflammatory disease that ultimately results in cirrhosis and liver failure. It is assosiciated with two step hit scenario; the first step is fat accumulationin liver and in the second step inflammation and fibrosis are the major compenents. The incidence of this disease is increasing worldwide, following rising incidences of obesity and diabetes mellitus. Aims: The aim of this study is to analyze the relationship between non-alcoholic fatty liver disease andseverity and neutrophilto- lymphocyte ratio among the patients having type 2 diabetes mellitus. Methods: This study involved 143 patients with type 2 diabetes who were placed into four groups (grade 0, 1, 2, 3) based on steatosis level due to blinded ultrasonographic evaluation. Biochemical parameters and counts of total white blood cells, neutrophils, and lymphocytes were determined. Neutrophil-tolymphocyte ratio was compared across the four patient groups. Results: Levels of hemoglobin A1c, creatinine, alanine aminotransferase, high-density lipoprotein cholesterol and triglycerides were significantly different between the four patient groups (ANOVA p-values: p <0.001, p=0.011, p=0.002, p=0.034, p=0.002, respectively). Counts of white blood cells, neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio significantly differed between the groups (p <0.001). Neutrophil-to-lymphocyte ratio was positively correlated with steatosis grade (p < 0.001). Conclusions: Neutrophil-to-lymphocyte ratio increases with increasing grade of non-alcoholic fatty liver disease in patients with type 2 diabetes, and may be a convenient marker to follow progression of non-alcoholic fatty liver disease.