Isfahan University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Prognostic Role of Neutrophil to Lymphocyte Ratio in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis Publisher Pubmed



Shavakhi M1 ; Nourigheimasi S2 ; Dioso E3 ; Goutnik M4 ; Luckewold B4 ; Khanzadeh S5 ; Heidari F6
Authors
Show Affiliations
Authors Affiliations
  1. 1. Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Iran
  2. 2. School of Medicine, Arak University of Medical Sciences, Arak, Iran
  3. 3. Department of Neurosurgery, University of Utah, Salt Lake City, United States
  4. 4. Department of Neurosurgery, University of Florida, Gainesville, United States
  5. 5. Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
  6. 6. Department of Community and Family Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

Source: Canadian Journal of Gastroenterology and Hepatology Published:2022


Abstract

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. Copyright © 2022 Mitra Shavakhi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Related Docs
View other Related Docs
1. Adaptation of Clinical Practice Guideline for Assessment of Liver Fibrosis in Patients With Non Alcoholic Fatty Liver Disease in Isfahan Province, International Journal of Preventive Medicine (2024)
2. Determination of Frequency of Diabetes and Pre-Diabetes in Patients With Nonalcoholic Fatty Liver Disease and Comparison With a Control Group, Journal of Isfahan Medical School (2016)
3. Intake of Nutrients, Fiber, and Sugar in Patients With Nonalcoholic Fatty Liver Disease in Comparison to Healthy Individuals, International Journal of Preventive Medicine (2016)
4. The Association Between the Dietary Inflammatory Index (Dii) and Some Serum Oxidative Stress Markers in Non-Alcoholic Fatty Liver Disease: Case-Control, International Journal of Preventive Medicine (2022)
5. Effect of a Moderately Carbohydrate-Restricted Diet on Liver Enzymes, Steatosis and Fibrosis in Normal-Weight Individuals With Non-Alcoholic Fatty Liver Disease: Study Protocol for a Parallel Randomised Controlled Clinical Trial, BMJ Open (2023)
6. The Association Between Major Dietary Patterns With the Risk of Non-Alcoholic Fatty Liver Disease, Oxidative Stress and Metabolic Parameters: A Case–Control Study, Journal of Diabetes and Metabolic Disorders (2022)
7. Prevalence of Nonalcoholic Fatty Liver Disease in Children With Renal Failure Underwent Treatment With Dialysis, International Journal of Preventive Medicine (2022)
8. Obesity and Air Pollution: Global Risk Factors for Pediatric Non-Alcoholic Fatty Liver Disease, Hepatitis Monthly (2011)
Experts (# of related papers)
View all Related Experts
Gholamreza Askari (9)
Awat Feizi (6)
Other Related Docs
9. First-Degree Relatives of Patients With Type 2 Diabetes Mellitus and Risk of Non-Alcoholic Fatty Liver Disease, Review of Diabetic Studies (2007)
10. The Effects of Fasting Diets on Nonalcoholic Fatty Liver Disease, Nutrition Reviews (2023)
11. The Effects of Curcumin Supplementation on Liver Function, Metabolic Profile and Body Composition in Patients With Non-Alcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, Complementary Therapies in Medicine (2020)
12. Probiotics As a Novel Treatment for Non-Alcoholic Fatty Liver Disease; a Systematic Review on the Current Evidences, Hepatitis Monthly (2013)
13. Effect of a Probiotic and Metformin on Liver Aminotransferases in Non-Alcoholic Steatohepatitis: A Double Blind Randomized Clinical Trial, International Journal of Preventive Medicine (2013)
14. Insulin-Like Growth Factor Binding Protein 3 Promoter Variant (Rs2854744) Is Associated With Nonalcoholic Fatty Liver Disease, Archives of Endocrinology and Metabolism (2023)
15. Serum Inflammatory Markers As Prognostic Marker for Nasopharyngeal Carcinoma With Liver Metastasis: A Multi-Center Retrospective Study, European Archives of Oto-Rhino-Laryngology (2024)
16. The Effects of Metformin Administration on Liver Enzymes and Body Composition in Non-Diabetic Patients With Non-Alcoholic Fatty Liver Disease And/Or Non-Alcoholic Steatohepatitis: An Up-To Date Systematic Review and Meta-Analysis of Randomized Controlled Trials, Pharmacological Research (2020)
17. Prevalence of Diabetic Neuropathy in Nonalcoholic Fatty Liver Disease (Nafld) Patients: A Systematic Review and Meta-Analysis, Neurology Asia (2024)
18. Diet Macronutrients Composition in Nonalcoholic Fatty Liver Disease: A Review on the Related Documents, Hepatitis Monthly (2014)
19. The Association of the Healthy Food Diversity Index With the Risk of Non-Alcoholic Fatty Liver Disease Among the Adult Population, Clinical Nutrition ESPEN (2024)
20. Dietary Quality Indices and Biochemical Parameters Among Patients With Non Alcoholic Fatty Liver Disease (Nafld), Hepatitis Monthly (2013)
21. A Comprehensive Insight Into the Effect of Berberine on Nonalcoholic Fatty Liver Disease (Nafld): A Systematic Review, Journal of Food Biochemistry (2023)
22. The Effects of Ursodeoxycholic Acid on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, BMC Cardiovascular Disorders (2025)
23. The Association of Dietary Phytochemical Index and Nonalcoholic Fatty Liver Disease, Food Science and Nutrition (2023)
24. Metabolic Syndrome and Nonalcoholic Fatty Liver Disease: Nutritional Approach for Prevention, Journal of Isfahan Medical School (2013)
25. Non-Alcoholic Steatohepatitis in a Sample of Iranian Adult Population: Age Is a Risk Factor, International Journal of Preventive Medicine (2011)
26. The Effect of a Mediterranean Diet on Metabolic Parameters in Patients With Non-Alcoholic Fatty Liver Disease: A Systematic Review of Randomized Controlled Trials, Clinical Nutrition ESPEN (2020)
27. Effects of the Mixture of Melissa Officinalis L., Cinnamomum Zeylanicutn and Urtica Dioica on Hepatic Enzymes Activity in Patients With Nonalcoholic Fatty Liver Disease, International Journal of Pharmacology (2012)
28. Dietary Phytochemical Index and the Risk of Non-Alcoholic Fatty Liver Disease: A Case-Control Study Among Iranian Adults, Complementary Therapies in Medicine (2022)
29. Hepatic Artery and Portal Vein Doppler Indexes in Non-Alcoholic Fatty Liver Disease Before and After Treatment to Prevent Unnecessary Health Care Costs, International Journal of Preventive Medicine (2014)
30. Treatment of Non-Alcoholic Fatty Liver Disease With Curcumin: A Randomized Placebo-Controlled Trial, Phytotherapy Research (2016)
31. The Role of Omega-3 Fatty Acids on the Prevention and Treatment of Non-Alcoholic Fatty Liver Disease: A Review of Published Papers, Journal of Isfahan Medical School (2014)
32. The Neutrophil-To-Lymphocyte Ratio Predicts Cardiovascular Outcomes in Patients With Diabetes a Systematic Review and Meta-Analysis, Cardiology in Review (2024)
33. The Effect of Synbiotic Supplementation on Body Composition and Lipid Profile in Patients With Nafld: A Randomized, Double Blind, Placebo-Controlled Clinical Trial Study, Iranian Red Crescent Medical Journal (2017)
34. The Effects of Mcc950 on Nlrp3 Inflammasome and Inflammatory Biomarkers: A Systematic Review and Meta-Analysis on Animal Studies, Immunopathologia Persa (2025)
35. Curcumin Supplementation Effect on Liver Enzymes in Patients With Nonalcoholic Fatty Liver Disease: A Grade-Assessed Systematic Review and Dose-Response Meta-Analysis of Randomized Controlled Trials, Nutrition reviews (2025)
36. Dietary Patterns and Risk of Non-Alcoholic Fatty Liver Disease, BMC Gastroenterology (2021)
37. Improving Data Adequacy of Ultrasonography Reports for Non-Alcoholic Fatty Liver Disease (Nafld) Through a National Structured Template, Acta Radiologica (2023)
38. Carbohydrate Quality Index and Risk of Non-Alcoholic Fatty Liver Disease in Iranian Adults, BMC Endocrine Disorders (2024)
39. Effect of Vitamin D Supplementation on C-Reactive Protein in Patients With Nonalcoholic Fatty Liver, International Journal of Preventive Medicine (2014)
40. The Effect of Symbiotic Supplementation on Liver Enzymes, C‑Reactive Protein and Ultrasound Findings in Patients With Non‑Alcoholic Fatty Liver Disease: A Clinical Trial, International Journal of Preventive Medicine (2016)
41. Vitamin E + Ursodeoxycholic Acid (Udca) Versus Vitamin E for the Treatment of Non-Alcoholic Steatohepatitis (Nash), Journal of Isfahan Medical School (2010)
42. The Effects of Low Carbohydrate Diets on Liver Function Tests in Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Clinical Trials, Journal of Research in Medical Sciences (2016)
43. Investigation of Cardiovascular Risk Factors in Diabetic and Nondiabetic Patients With Nonalcoholic Fatty Liver Disease, Journal of Research in Medical Sciences (2024)
44. Is the Neutrophil-To-Lymphocyte Ratio an Exceptional Indicator for Metabolic Syndrome Disease and Outcomes?, Endocrine Practice (2022)
45. Efficacy of Resveratrol Supplementation in Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis of Clinical Trials, Complementary Therapies in Clinical Practice (2021)
46. Doppler Perfusion Index in Adolescents With Nonalcoholic Fatty Liver Disease, Immunopathologia Persa (2021)
47. The Relationship Between Dietary Antioxidant Intake and Physical Activity Rate With Nonalcoholic Fatty Liver Disease (Nafld): A Case – Control Study, Clinical Nutrition ESPEN (2019)
48. Association Between Dietary Glycemic Index and Non-Alcoholic Fatty Liver Disease in Patients With Type 2 Diabetes Mellitus, Frontiers in Endocrinology (2023)
49. Effects of Vitamin D Supplementation on Liver Fibrogenic Factors in Non-Alcoholic Fatty Liver Patients With Steatohepatitis: Study Protocol for a Randomized Clinical Trial, Trials (2019)
50. Neutrophil to Lymphocyte Ratio (Nlr) Prognostic Effects on Heart Failure; a Systematic Review and Meta-Analysis, BMC Cardiovascular Disorders (2023)