The Neutrophil-to-Lymphocyte Ratio as A Noninvasive Marker in Patients with Biopsy-Proven Non-Alcoholic Steatohepatitis

Asıl, Mehmet; Dertli, Ramazan

doi:10.5152/imj.2016.74755

Cited by 5 publications

(8 citation statements)

References 14 publications

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“…To the best of our knowledge, this is the first study to use TE and CAP to determine the correlation between NLR and the degree of steatosis and fibrosis of NAFLD, as studies have shown about association between NLR and NAFLD, 13,16,20,21 TE and CAP as additional tool to transabdominal US for NAFLD evaluation has been validated for steatosis and fibrosis assessment. 25 In this study, the proportion of women was higher than men (62.3% vs 37.7%).…”

Section: Discussionmentioning

confidence: 96%

“…Samples were collected at Dr. Cipto Mangunkusumo National General Hospital, Jakarta based on database review from medical records in 2 years' period (2016)(2017)(2018). Samples from this study using consecutive sampling techniques with inclusion criteria: (1) NAFLD patients, (2) Age over 18 years; while the exclusion criteria were (1) Hepatitis B and hepatitis C, (2) Alcohol consumption ≥ 20 grams/day in the past 1 year, (3) Acute hepatitis, biliary obstruction, liver congestion, liver tumors, and ascites, (4) state of fever or bacterial or viral infection, (5) Patients with hematologic malignancies, (6) Patients with solid tumors, (7) Patients undergoing chemotherapy, (8) Patients with a history of cardiovascular disease, (9) Patients with autoimmune diseases, (10) Patients with aplastic anemia, myelodysplastic syndrome, (11) Patients infected with HIV, (12) Patients receiving long-term immunosuppressive therapy, (13) Incomplete research data.…”

Section: Methodsmentioning

confidence: 99%

“…11 Liver biopsy is still considered the gold standard for diagnosing NASH, but this procedure is less preferred because of its possible complications, such as bleeding and even death (1: 10.000). 12,13 In addition, this procedure is also costly, has a large sampling error (± 1/50.000 total volume), poor reproducibility, and is strongly influenced by the operator who does it as well as the pathologist who assesses the liver specimen. 12,14 Transient elastography (TE) is a noninvasive and rapid measurement tool, which has been proven to have a good accuracy in evaluating the degree of liver fibrosis and steatosis.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Value of Neutrophil to Lymphocyte Ratio in Non-Alcoholic Fatty Liver Disease Evaluated Using Transient Elastography (TE) with Controlled Attenuated Parameter (CAP)

Lesmana¹,

Kencana²,

Rinaldi³

et al. 2022

DMSO

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Background: Non-alcoholic fatty liver disease (NAFLD) is a chronic inflammatory disease with excessive fat accumulation in the liver. Transient elastography (TE) with controlled attenuation parameter (CAP) is a device and method to examine the degree of fibrosis and steatosis. However, this device is not widely available across Indonesia. Neutrophil and lymphocyte ratio (NLR) is a simple marker for inflammation, which has a potency to predict disease outcome. This study aims to know the diagnostic value of NLR as the indicator of steatosis and fibrosis severity. Methods: This was a cross-sectional study with consecutive sample collection. We used secondary data from medical records, starting from 2016 to 2018. A descriptive and data analysis, including correlation test, multivariate linear regression, t-test, receiver operating curve (ROC) and area under the curve (AUC) were done to find out the outcome of the study. Statistical analyses were performed using Statistical Package for Social Sciences (SPSS) Version 20.0 (SPSS Inc, Chicago, Illinois). A P value <0.05 was considered as statistically significant.Results: Out of 106 subjects, 62.3% patients were women with the mean of age 57.29 years old and 77.4% had metabolic syndrome. Most patients had moderate to severe steatosis degree (66%) with the mean of TE mean 6.14 (2.8-18.2) kPa. There was a positive correlation between CAP and TE compared with NLR with r = 0.648 (p < 0.001) and r = 0.621 (p < 0.001), respectively. The use of RNL to assess moderate-severe steatosis has a cutoff point of 1.775 with sensitivity, specificity, PPV and NPV, respectively, at 81.5%, 80.6%, 89.1%, and 69.1%; cutoff point 2.150 to assess significant fibrosis with sensitivity, specificity, PPV and NPV of 92.3%, 87.5%, 70.6%, and 97.2%, respectively. Conclusion: NLR has a positive and significant correlation with the degree of steatosis and fibrosis with high sensitivity and specificity as evaluated by TE/CAP.

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnostic Value of Neutrophil to Lymphocyte Ratio in Non-Alcoholic Fatty Liver Disease Evaluated Using Transient Elastography (TE) with Controlled Attenuated Parameter (CAP)

Lesmana¹,

Kencana²,

Rinaldi³

et al. 2022

DMSO

View full text Add to dashboard Cite

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“…[2] e neutrophil to lymphocyte ratio (NLR) is an easily obtained serum measure that corresponds to systemic in ammation and has been demonstrated to be a useful prognostic measure in a variety of pathologies, including stroke and colorectal cancer. [3,4] In several studies, NLR has been positively associated with NASH and brosis stage in patients with NAFLD [5][6][7][8][9][10][11][12][13][14][15][16][17]. us, NLR might serve as an easily obtainable predictive tool to guide clinical decision-making, intervene earlier and improve patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Role of Neutrophil to Lymphocyte Ratio in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

Shavakhi

Nourigheimasi

Dioso

et al. 2022

Canadian Journal of Gastroenterology and Hepatology

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Introduction. Nonalcoholic steatohepatitis (NASH) and liver fibrosis are the most common complications of nonalcoholic fatty liver disease (NAFLD). In this systematic review and meta-analysis, we aim to analyze the current literature to evaluate the association of neutrophil to lymphocyte ratio (NLR) with NASH and fibrosis in patients with NAFLD. Methods. PubMed, Web of Science, and Scopus were used to conduct a systematic search for relevant publications published before May 24, 2022. The Newcastle–Ottawa scale was used for quality assessment. Results. Thirteen studies were included in our study. The pooled results showed that NAFLD patients with significant NASH had elevated levels of NLR compared to those with nonsignificant or without NASH (SMD = 0.97, 95% CI = 0.59–1.39, p < 0.001 ). The pooled sensitivity and specificity of NLR were 78.16% (95% CI = 73.70%–82.04%), and 76.93% (95% CI = 70.22%–82.50%), respectively. In addition, NAFLD patients with significant liver fibrosis had elevated levels of NLR compared to those with nonsignificant or without fibrosis (SMD = 1.59, 95% CI = 0.76–2.43, p < 0.001 ). The pooled sensitivity and specificity of NLR were 82.62% (95% CI = 70.235%–90.55%) and 81.22% (95% CI = 75.62%–85.78%), respectively. Conclusion. Our findings support NLR to be a promising biomarker that can be readily integrated into clinical settings to aid in the prediction and prevention of NASH and fibrosis among patients with NAFLD.

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“…[5,7] There are many studies in the literature showing the importance of inflammatory biochemical and hematological markers (e.g., colorectal cancer, pancreatic adenocarcinoma, non-alcoholic steatohepatitis, liver fibrosis, and cirrhosis). [8][9][10][11] There are studies presenting the prognostic significance of NLR and PLR levels in the course of chronic diseases such as hypertension, diabetes mellitus, metabolic syndrome, and chronic kidney failure. [6,7,12] NLR and PLR levels are fast workable, cheap, and easy to calculate parameters.…”

Section: Introductionmentioning

confidence: 99%

Can Neutrophil Lymphocyte Ratio Predict Mortality in Acute Non Variceal Upper Gastrointestinal Bleeding?

Dertli¹

2021

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Acute non-variceal upper gastrointestinal bleeding (NVUGIB) is one of the common gastrointestinal problems and has a high mortality, especially in patients with poor hemodynamics. Therefore, treatment and follow-up should be managed dynamically. Neutrophil-lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) are fast workable, cheap, and easy to calculate hematological parameters. We need easily accessible parameters as well as routine classifications such as Rockall score in the treatment and follow-up of NVUGIB patients, whose hemodynamics are unstable and progress with high mortality. In this study, we planned to evaluate NLR and PLR levels in patients with NVUGIB in the treatment follow-up with other scoring systems and their relationship with mortality in these patients. METHODS:Two hundred and forty-nine patients who were admitted to our clinic between January 2015 and January 2017 diagnosed with NVUGIB, and who underwent necessary examinations and follow-ups, were included in the study. The patients' Glasgow Blacthford, Rockall Score, NLR, and PLR levels were calculated at the first admission. RESULTS:One hundred and fifty-six of the patients were male (70.6%) and the mean age of all patients was 64.5±18.0 years. After follow-up and treatment, 28 (11.2%) patients died due to bleeding. High NLR and tachycardia at the time of admission and high patient age were found to be independent risk factors affecting the long of hospital stay. High Rockall score, high NLR at admission, and hypotension at admission were shown to be independent risk factors affecting mortality. CONCLUSION:Besides the use of various scoring systems in patients with NVUGIB, we think that the use of simple hematological parameters may be appropriate and the use of these hematological parameters may be useful in the management of patients with unstable hemodynamics.

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The Neutrophil-to-Lymphocyte Ratio as A Noninvasive Marker in Patients with Biopsy-Proven Non-Alcoholic Steatohepatitis

Cited by 5 publications

References 14 publications

Diagnostic Value of Neutrophil to Lymphocyte Ratio in Non-Alcoholic Fatty Liver Disease Evaluated Using Transient Elastography (TE) with Controlled Attenuated Parameter (CAP)

Diagnostic Value of Neutrophil to Lymphocyte Ratio in Non-Alcoholic Fatty Liver Disease Evaluated Using Transient Elastography (TE) with Controlled Attenuated Parameter (CAP)

Prognostic Role of Neutrophil to Lymphocyte Ratio in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis

Can Neutrophil Lymphocyte Ratio Predict Mortality in Acute Non Variceal Upper Gastrointestinal Bleeding?

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