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


OBJECTIVE
The aim of this study is to analyze the relationship between non-alcoholic fatty liver disease andseverity and neutrophil-to-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-to-lymphocyte 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. (Acta gastro-enterol. belg., 2016, 79, 295-300).
N K
NK
Kahraman
C
C
Kahraman
F E
FE
Koçak
S
S
Coşgun
B
B
Şanal
M
M
Korkmaz
Z
Z
Bayhan
S
S
Zeren
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis; D018450:Disease Progression; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D018655:Lymphocyte Count / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013223:Statistics as Topic
D015415:Biomarkers