Among 6613 adults, specific systemic inflammatory biomarkers are significantly associated with metabolic dysfunction-associated steatotic liver disease () risk.
and are negatively associated with MASLD risk, while , , and show a positive association.
Most biomarkers, including ALI, SIRI, IBI, CAR, LMR, and PNI, have significant non-linear correlations with MASLD.
Age-related differences significantly influence the association between ALI and MASLD risk.
Variations in the relationship between PNI and MASLD risk are observed across different cardiovascular outcomes.
Simplified
BACKGROUND: Metabolic dysfunction-associated steatotic liver disease () is a primary cause of chronic liver disease, with potential progression to cirrhosis and hepatocellular carcinoma (HCC). Although systemic inflammatory biomarkers are associated with liver diseases, their specific role in MASLD remains unclear. This study examines the association between systemic inflammatory biomarkers and MASLD.
METHODS: This cross-sectional study enrolled 6613 adults aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES) spanning from 2017 to March 2020. Among these participants,, 34.67% were aged 40-59 years, 50.85% were female, and 63.26% were Non-Hispanic White. We investigated 10 inflammatory biomarkers: , SIRI, SII, SIPS, IBI, , , , LMR, and . Logistic regression models were performed to assess the linear association between systemic inflammatory biomarkers and MASLD. Restricted cubic spline (RCS) regression was employed to explore potential nonlinear relationships between biomarkers and MASLD risk. Additionally, subgroup analyses were conducted to examine the influence of various demographic and clinical characteristics on the observed associations.
RESULTS: After adjusting for key confounders, NLR and PLR exhibited negative association with MASLD risk, while ALI, CAR, and PNI exhibited the opposite association (P < 0.05). Most biomarkers, including ALI, SIRI, IBI, CAR, LMR, and PNI, exhibited significant non-linear correlations with MASLD (P < 0.05). Subgroup analyses revealed substantial age-related differences in the association between ALI and MASLD risk, as well as varying relationships between PNI and MASLD risk across various cardiovascular outcomes (P < 0.05).
CONCLUSION: Systemic inflammatory biomarkers are significantly associated with MASLD risk. Large-scale prospective studies are warranted to confirm these findings and elucidate the underlying mechanisms.
Key numbers
29.8–45.2%
Prevalence of
Estimated prevalence range of in the United States.
6613 adults
Study Population Size
Total number of adults assessed in the NHANES study.
34.67% aged 40-59 years
Age Group Proportion
Percentage of participants in the 40-59 age group.
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Declarations. Ethics approval and consent to participate: The study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki as reflected in a priori approval by the Ethics Review Board of the National Center for Health Statistics (NCHS). Written informed consent was obtained from all patients included in the study. Consent for publication: Not Applicable Competing interests: The authors declare no competing interests.
