Association between neutrophil-albumin ratio and ultrasound-defined metabolic dysfunction-associated fatty liver disease in U.S. adults: evidence from NHANES 2017–2018
Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its pathogenesis. This study aimed to investigate the relationship between neutrophil-albumin ratio (NAR) and MAFLD. Methods This population-based s...
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| Published in | BMC gastroenterology Vol. 25; no. 1; pp. 20 - 10 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
London
BioMed Central
17.01.2025
BioMed Central Ltd BMC |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1471-230X 1471-230X |
| DOI | 10.1186/s12876-025-03612-9 |
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| Abstract | Background
Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its pathogenesis. This study aimed to investigate the relationship between neutrophil-albumin ratio (NAR) and MAFLD.
Methods
This population-based study was performed using data from NHANES 2017–2018 and included 4526 individuals with a median age of 44 years old, and the males account for 46.13% (
n
= 2088). Ultrasound-defined MAFLD was diagnosed using a controlled attenuation parameter (CAP) threshold of ≥ 285 dB/m. Differences in baseline characteristics between patients with CAP ≥ 285 dB/m and < 285 dB/m were analyzed. A generalized additive model (GAM) and restricted cubic splines (RCS) were applied to explore the nonlinear relationship between NAR and CAP, followed by generalized linear models (GLMs). Threshold effect analysis was performed to identify the inflection point in the nonlinear relationship. CAP-related variables were ranked using XG Boost and random forest algorithms, and predictive models were developed and evaluated.
Results
The study population included 1,503 patients with CAP ≥ 285 dB/m. NAR was significantly elevated in subjects with CAP ≥ 285 dB/m (
P
< 0.001), and nonlinear relationships between NAR and CAP were observed. NAR was positively associated with CAP in three GLMs, and this relationship remained after adjusting for confounding factors or dividing NAR into tertiles. Additionally, when NAR < 1.436, a one-unit rise in NAR was linked to a 3.304-fold increase in the risk of NAFLD (OR = 3.304, 95% CI: 2.649–4.122). The NAR-based random forest model showed the best predictive performance with AUC values of 0.978 (training) and 0.813 (validation).
Conclusion
NAR is positively associated with CAP, and the NAR-based random forest model is optimal for predicting MAFLD risk, highlighting the importance of NAR in predicting MAFLD. |
|---|---|
| AbstractList | Abstract Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its pathogenesis. This study aimed to investigate the relationship between neutrophil-albumin ratio (NAR) and MAFLD. Methods This population-based study was performed using data from NHANES 2017–2018 and included 4526 individuals with a median age of 44 years old, and the males account for 46.13% (n = 2088). Ultrasound-defined MAFLD was diagnosed using a controlled attenuation parameter (CAP) threshold of ≥ 285 dB/m. Differences in baseline characteristics between patients with CAP ≥ 285 dB/m and < 285 dB/m were analyzed. A generalized additive model (GAM) and restricted cubic splines (RCS) were applied to explore the nonlinear relationship between NAR and CAP, followed by generalized linear models (GLMs). Threshold effect analysis was performed to identify the inflection point in the nonlinear relationship. CAP-related variables were ranked using XG Boost and random forest algorithms, and predictive models were developed and evaluated. Results The study population included 1,503 patients with CAP ≥ 285 dB/m. NAR was significantly elevated in subjects with CAP ≥ 285 dB/m (P < 0.001), and nonlinear relationships between NAR and CAP were observed. NAR was positively associated with CAP in three GLMs, and this relationship remained after adjusting for confounding factors or dividing NAR into tertiles. Additionally, when NAR < 1.436, a one-unit rise in NAR was linked to a 3.304-fold increase in the risk of NAFLD (OR = 3.304, 95% CI: 2.649–4.122). The NAR-based random forest model showed the best predictive performance with AUC values of 0.978 (training) and 0.813 (validation). Conclusion NAR is positively associated with CAP, and the NAR-based random forest model is optimal for predicting MAFLD risk, highlighting the importance of NAR in predicting MAFLD. Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its pathogenesis. This study aimed to investigate the relationship between neutrophil-albumin ratio (NAR) and MAFLD. This population-based study was performed using data from NHANES 2017-2018 and included 4526 individuals with a median age of 44 years old, and the males account for 46.13% (n = 2088). Ultrasound-defined MAFLD was diagnosed using a controlled attenuation parameter (CAP) threshold of ≥ 285 dB/m. Differences in baseline characteristics between patients with CAP ≥ 285 dB/m and < 285 dB/m were analyzed. A generalized additive model (GAM) and restricted cubic splines (RCS) were applied to explore the nonlinear relationship between NAR and CAP, followed by generalized linear models (GLMs). Threshold effect analysis was performed to identify the inflection point in the nonlinear relationship. CAP-related variables were ranked using XG Boost and random forest algorithms, and predictive models were developed and evaluated. The study population included 1,503 patients with CAP ≥ 285 dB/m. NAR was significantly elevated in subjects with CAP ≥ 285 dB/m (P < 0.001), and nonlinear relationships between NAR and CAP were observed. NAR was positively associated with CAP in three GLMs, and this relationship remained after adjusting for confounding factors or dividing NAR into tertiles. Additionally, when NAR < 1.436, a one-unit rise in NAR was linked to a 3.304-fold increase in the risk of NAFLD (OR = 3.304, 95% CI: 2.649-4.122). The NAR-based random forest model showed the best predictive performance with AUC values of 0.978 (training) and 0.813 (validation). NAR is positively associated with CAP, and the NAR-based random forest model is optimal for predicting MAFLD risk, highlighting the importance of NAR in predicting MAFLD. Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its pathogenesis. This study aimed to investigate the relationship between neutrophil-albumin ratio (NAR) and MAFLD. Methods This population-based study was performed using data from NHANES 2017–2018 and included 4526 individuals with a median age of 44 years old, and the males account for 46.13% ( n = 2088). Ultrasound-defined MAFLD was diagnosed using a controlled attenuation parameter (CAP) threshold of ≥ 285 dB/m. Differences in baseline characteristics between patients with CAP ≥ 285 dB/m and < 285 dB/m were analyzed. A generalized additive model (GAM) and restricted cubic splines (RCS) were applied to explore the nonlinear relationship between NAR and CAP, followed by generalized linear models (GLMs). Threshold effect analysis was performed to identify the inflection point in the nonlinear relationship. CAP-related variables were ranked using XG Boost and random forest algorithms, and predictive models were developed and evaluated. Results The study population included 1,503 patients with CAP ≥ 285 dB/m. NAR was significantly elevated in subjects with CAP ≥ 285 dB/m ( P < 0.001), and nonlinear relationships between NAR and CAP were observed. NAR was positively associated with CAP in three GLMs, and this relationship remained after adjusting for confounding factors or dividing NAR into tertiles. Additionally, when NAR < 1.436, a one-unit rise in NAR was linked to a 3.304-fold increase in the risk of NAFLD (OR = 3.304, 95% CI: 2.649–4.122). The NAR-based random forest model showed the best predictive performance with AUC values of 0.978 (training) and 0.813 (validation). Conclusion NAR is positively associated with CAP, and the NAR-based random forest model is optimal for predicting MAFLD risk, highlighting the importance of NAR in predicting MAFLD. Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its pathogenesis. This study aimed to investigate the relationship between neutrophil-albumin ratio (NAR) and MAFLD.BACKGROUNDMetabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its pathogenesis. This study aimed to investigate the relationship between neutrophil-albumin ratio (NAR) and MAFLD.This population-based study was performed using data from NHANES 2017-2018 and included 4526 individuals with a median age of 44 years old, and the males account for 46.13% (n = 2088). Ultrasound-defined MAFLD was diagnosed using a controlled attenuation parameter (CAP) threshold of ≥ 285 dB/m. Differences in baseline characteristics between patients with CAP ≥ 285 dB/m and < 285 dB/m were analyzed. A generalized additive model (GAM) and restricted cubic splines (RCS) were applied to explore the nonlinear relationship between NAR and CAP, followed by generalized linear models (GLMs). Threshold effect analysis was performed to identify the inflection point in the nonlinear relationship. CAP-related variables were ranked using XG Boost and random forest algorithms, and predictive models were developed and evaluated.METHODSThis population-based study was performed using data from NHANES 2017-2018 and included 4526 individuals with a median age of 44 years old, and the males account for 46.13% (n = 2088). Ultrasound-defined MAFLD was diagnosed using a controlled attenuation parameter (CAP) threshold of ≥ 285 dB/m. Differences in baseline characteristics between patients with CAP ≥ 285 dB/m and < 285 dB/m were analyzed. A generalized additive model (GAM) and restricted cubic splines (RCS) were applied to explore the nonlinear relationship between NAR and CAP, followed by generalized linear models (GLMs). Threshold effect analysis was performed to identify the inflection point in the nonlinear relationship. CAP-related variables were ranked using XG Boost and random forest algorithms, and predictive models were developed and evaluated.The study population included 1,503 patients with CAP ≥ 285 dB/m. NAR was significantly elevated in subjects with CAP ≥ 285 dB/m (P < 0.001), and nonlinear relationships between NAR and CAP were observed. NAR was positively associated with CAP in three GLMs, and this relationship remained after adjusting for confounding factors or dividing NAR into tertiles. Additionally, when NAR < 1.436, a one-unit rise in NAR was linked to a 3.304-fold increase in the risk of NAFLD (OR = 3.304, 95% CI: 2.649-4.122). The NAR-based random forest model showed the best predictive performance with AUC values of 0.978 (training) and 0.813 (validation).RESULTSThe study population included 1,503 patients with CAP ≥ 285 dB/m. NAR was significantly elevated in subjects with CAP ≥ 285 dB/m (P < 0.001), and nonlinear relationships between NAR and CAP were observed. NAR was positively associated with CAP in three GLMs, and this relationship remained after adjusting for confounding factors or dividing NAR into tertiles. Additionally, when NAR < 1.436, a one-unit rise in NAR was linked to a 3.304-fold increase in the risk of NAFLD (OR = 3.304, 95% CI: 2.649-4.122). The NAR-based random forest model showed the best predictive performance with AUC values of 0.978 (training) and 0.813 (validation).NAR is positively associated with CAP, and the NAR-based random forest model is optimal for predicting MAFLD risk, highlighting the importance of NAR in predicting MAFLD.CONCLUSIONNAR is positively associated with CAP, and the NAR-based random forest model is optimal for predicting MAFLD risk, highlighting the importance of NAR in predicting MAFLD. Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its pathogenesis. This study aimed to investigate the relationship between neutrophil-albumin ratio (NAR) and MAFLD. This population-based study was performed using data from NHANES 2017-2018 and included 4526 individuals with a median age of 44 years old, and the males account for 46.13% (n = 2088). Ultrasound-defined MAFLD was diagnosed using a controlled attenuation parameter (CAP) threshold of [greater than or equal to] 285 dB/m. Differences in baseline characteristics between patients with CAP [greater than or equal to] 285 dB/m and < 285 dB/m were analyzed. A generalized additive model (GAM) and restricted cubic splines (RCS) were applied to explore the nonlinear relationship between NAR and CAP, followed by generalized linear models (GLMs). Threshold effect analysis was performed to identify the inflection point in the nonlinear relationship. CAP-related variables were ranked using XG Boost and random forest algorithms, and predictive models were developed and evaluated. The study population included 1,503 patients with CAP [greater than or equal to] 285 dB/m. NAR was significantly elevated in subjects with CAP [greater than or equal to] 285 dB/m (P < 0.001), and nonlinear relationships between NAR and CAP were observed. NAR was positively associated with CAP in three GLMs, and this relationship remained after adjusting for confounding factors or dividing NAR into tertiles. Additionally, when NAR < 1.436, a one-unit rise in NAR was linked to a 3.304-fold increase in the risk of NAFLD (OR = 3.304, 95% CI: 2.649-4.122). The NAR-based random forest model showed the best predictive performance with AUC values of 0.978 (training) and 0.813 (validation). NAR is positively associated with CAP, and the NAR-based random forest model is optimal for predicting MAFLD risk, highlighting the importance of NAR in predicting MAFLD. Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its pathogenesis. This study aimed to investigate the relationship between neutrophil-albumin ratio (NAR) and MAFLD. Methods This population-based study was performed using data from NHANES 2017-2018 and included 4526 individuals with a median age of 44 years old, and the males account for 46.13% (n = 2088). Ultrasound-defined MAFLD was diagnosed using a controlled attenuation parameter (CAP) threshold of [greater than or equal to] 285 dB/m. Differences in baseline characteristics between patients with CAP [greater than or equal to] 285 dB/m and < 285 dB/m were analyzed. A generalized additive model (GAM) and restricted cubic splines (RCS) were applied to explore the nonlinear relationship between NAR and CAP, followed by generalized linear models (GLMs). Threshold effect analysis was performed to identify the inflection point in the nonlinear relationship. CAP-related variables were ranked using XG Boost and random forest algorithms, and predictive models were developed and evaluated. Results The study population included 1,503 patients with CAP [greater than or equal to] 285 dB/m. NAR was significantly elevated in subjects with CAP [greater than or equal to] 285 dB/m (P < 0.001), and nonlinear relationships between NAR and CAP were observed. NAR was positively associated with CAP in three GLMs, and this relationship remained after adjusting for confounding factors or dividing NAR into tertiles. Additionally, when NAR < 1.436, a one-unit rise in NAR was linked to a 3.304-fold increase in the risk of NAFLD (OR = 3.304, 95% CI: 2.649-4.122). The NAR-based random forest model showed the best predictive performance with AUC values of 0.978 (training) and 0.813 (validation). Conclusion NAR is positively associated with CAP, and the NAR-based random forest model is optimal for predicting MAFLD risk, highlighting the importance of NAR in predicting MAFLD. Keywords: Metabolic dysfunction-associated fatty liver disease, Controlled attenuation parameter, Neutrophil-albumin ratio, Predictive model, Cross-sectional study BackgroundMetabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its pathogenesis. This study aimed to investigate the relationship between neutrophil-albumin ratio (NAR) and MAFLD.MethodsThis population-based study was performed using data from NHANES 2017–2018 and included 4526 individuals with a median age of 44 years old, and the males account for 46.13% (n = 2088). Ultrasound-defined MAFLD was diagnosed using a controlled attenuation parameter (CAP) threshold of ≥ 285 dB/m. Differences in baseline characteristics between patients with CAP ≥ 285 dB/m and < 285 dB/m were analyzed. A generalized additive model (GAM) and restricted cubic splines (RCS) were applied to explore the nonlinear relationship between NAR and CAP, followed by generalized linear models (GLMs). Threshold effect analysis was performed to identify the inflection point in the nonlinear relationship. CAP-related variables were ranked using XG Boost and random forest algorithms, and predictive models were developed and evaluated.ResultsThe study population included 1,503 patients with CAP ≥ 285 dB/m. NAR was significantly elevated in subjects with CAP ≥ 285 dB/m (P < 0.001), and nonlinear relationships between NAR and CAP were observed. NAR was positively associated with CAP in three GLMs, and this relationship remained after adjusting for confounding factors or dividing NAR into tertiles. Additionally, when NAR < 1.436, a one-unit rise in NAR was linked to a 3.304-fold increase in the risk of NAFLD (OR = 3.304, 95% CI: 2.649–4.122). The NAR-based random forest model showed the best predictive performance with AUC values of 0.978 (training) and 0.813 (validation).ConclusionNAR is positively associated with CAP, and the NAR-based random forest model is optimal for predicting MAFLD risk, highlighting the importance of NAR in predicting MAFLD. |
| ArticleNumber | 20 |
| Audience | Academic |
| Author | He, Ming-yu Liu, Yi-ming Du, Xin-jie |
| Author_xml | – sequence: 1 givenname: Ming-yu surname: He fullname: He, Ming-yu organization: Ultrasonography Department, Longyan First Hospital – sequence: 2 givenname: Xin-jie surname: Du fullname: Du, Xin-jie organization: Thyroid and Breast Surgery Department, Longyan First Hospital – sequence: 3 givenname: Yi-ming surname: Liu fullname: Liu, Yi-ming email: anhei4daigou@163.com organization: Gastroenterology Department, Longyan First Hospital |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/39833665$$D View this record in MEDLINE/PubMed |
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| Keywords | Controlled attenuation parameter Neutrophil-albumin ratio Cross-sectional study Metabolic dysfunction-associated fatty liver disease Predictive model |
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Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its... Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its pathogenesis.... Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its... BackgroundMetabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role in its... Abstract Background Metabolic dysfunction-associated fatty liver disease (MAFLD) is increasingly prevalent, and systemic inflammation markers may play a role... |
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| SubjectTerms | Adult Albumin Analysis Biomarkers - blood Blood Blood pressure Body mass index Care and treatment Controlled attenuation parameter Creatinine Cross-sectional study Diabetes Diagnosis Disease prevention Expected values Fatty liver Female Gastroenterology Gender Generalized linear models Hepatitis Hepatology Humans Hypertension Inflammation Internal Medicine Leukocytes (neutrophilic) Liver cirrhosis Liver diseases Male Medical examination Medical laboratories Medicine Medicine & Public Health Metabolic dysfunction-associated fatty liver disease Metabolic syndrome Middle Aged Neutrophil-albumin ratio Neutrophils Non-alcoholic Fatty Liver Disease - blood Non-alcoholic Fatty Liver Disease - diagnostic imaging Nutrition Nutrition Surveys Nutritional status Physiology, Pathological Population studies Prediction models Predictive model Prevalence studies (Epidemiology) Serum Albumin - analysis Smoking Sociodemographics Triglycerides Ultrasonic imaging Ultrasonography Ultrasound United States - epidemiology Uric acid |
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| Title | Association between neutrophil-albumin ratio and ultrasound-defined metabolic dysfunction-associated fatty liver disease in U.S. adults: evidence from NHANES 2017–2018 |
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