COMPARISON OF NEUTROPHIL LYMPHOCYTE RATIO AND PLATELET LYMPHOCYTE RATIO WITH THE DEGREE OF HEPATOSTEATOSIS IN OVERWEIGHT CHILDREN DIAGNOSED WITH NON-ALCOHOLIC FATTY LIVER DISEASE

Year 2025, Volume: 26 Issue: 3, 207 - 211, 16.07.2025

Arzu Gülseren , Didem Gulcu Taskin

https://doi.org/10.18229/kocatepetip.1591250

Abstract

OBJECTIVE: We aimed to evaluate whether neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) values differ in grade 1 and 2 hepatosteatosis.
MATERIAL AND METHODS: For the study, the records of patients diagnosed with hepatosteatosis in the pediatric gastroenterology department between 2021 and 2023 were examined retrospectively. Patients younger than eighteen years of age and diagnosed with hepatosteatosis on sonographic examination were included in the study.
RESULTS: Seventy-six patients under 18 years of age with hepatosteatosis were evaluated. Fifty-three (69.7%) patients were grade 1 and 23 (30.3%) were grade 2. The mean age of grade 2 patients (12.0 ± 3.9) was higher than that of grade 1 patients (9.5 ± 2.6). Body mass index was reported to be higher in the grade 2 hepatosteatosis (21.4 ± 2.5 vs 25.8 ± 4.7; P < 0.001). AST (28.1 ± 12.9 vs 35.2 ± 22.2; P= 0.088) and ALT (32.0 ± 15.3 vs 39.5 ± 21.4; P= 0.089) values were higher in the grade 2 group but were not significantly different. NLR (2.5 ± 1.2 vs 3.2 ± 1.7; P= 0.041) and PLR (140 ± 58 vs 175 ± 75; P= 0.031) were significantly higher in the grade 2.
CONCLUSIONS: NLR and PLR values are likely to be used as parameters with high predictive value in the progression of hepatosteatosis. The role of the inflammatory process in the progression of hepatosteatosis is important.

Keywords

Hepatosteatosis , Neutrophil-lymphocyte ratio , Platelet-lymphocyte ratio , Aspartate aminotransferase , Alanine aminotransferase.

ALKOLİK OLMAYAN YAĞLI KARACİĞER HASTALIĞI TANISI ALAN AŞIRI KİLOLU ÇOCUKLARDA NÖTROFİL LENFOSİT ORANI VE TROMBOSİT LENFOSİT ORANININ HEPATOSTEATOZ DERECESİYLE KARŞILAŞTIRILMASI

Abstract

AMAÇ: Nötrofil-lenfosit oranı (NLR) ve trombosit-lenfosit oranı (PLR) değerlerinin grade 1 ve 2 hepatosteatozda farklı olup olmadığını değerlendirmeyi amaçladık.
GEREÇ VE YÖNTEM: Çalışma için 2021 - 2023 yılları arasında pediatrik gastroenteroloji bölümünde hepatosteatoz tanısı alan hastaların kayıtları retrospektif olarak incelendi. Çalışmaya 18 yaşından küçük ve ultrasonografide hepatosteatoz tanısı alan hastalar dahil edildi.
BULGULAR: 18 yaş altı hepatosteatozlu 76 hasta değerlendirildi. Elli üç (%69,7) hasta grade 1 ve 23 (%30,3) hasta grade 2 idi. Grade 2 hastaların yaş ortalaması (12,0 ± 3,9), grade 1 hastaların yaş ortalamasından (9,5 ± 2,6) daha yüksekti. Vücut kitle indeksinin grade 2 hepatosteatozda daha yüksek olduğu bildirildi (21,4 ± 2,5'e karşı 25,8 ± 4,7; P < 0,001). Aspartat aminotransferaz (AST) (28,1 ± 12,9'a karşı 35,2 ± 22,2; P = 0,088) ve Alanin aminotransferaz (ALT) (32,0 ± 15,3'e karşı 39,5 ± 21,4; P = 0,089) değerleri grade 2 grubunda daha yüksekti ancak anlamlı olarak farklı değildi. NLR (2,5 ± 1,2 vs 3,2 ± 1,7; P= 0,041) ve PLR (140 ± 58 vs 175 ± 75; P= 0,031) grade 2'de anlamlı derecede daha yüksekti.
SONUÇ: NLR ve PLR değerlerinin hepatosteatozun ilerlemesinde yüksek öngörücü değere sahip parametreler olarak kullanılması muhtemeldir. Hepatosteatozun ilerlemesinde inflamatuvar sürecin rolü önemlidir.

Keywords

Hepatosteatoz , Nötrofil-lenfosit oranı , Trombosit-lenfosit oranı , Aspartat aminotransferaz , Alanin aminotransferaz.

References

• 1. Vos MB, Abrams SH, Barlow SE, et al. NASPGHAN Clinical Practice Guideline for the Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease in Children: Recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr. 2017;64(2):319-34.
• 2. Paixão TM, Siqueira CEG, Tristan-Cheever E, et al. Overweight and Obesity in Brazilian Immigrants in Massachusetts, USA: A Time Series Analysis (2009-2020). Obes Facts. 2023;16(2):109-18.
• 3. Aslan A, Erdemli S, Günaydın GD, et al. Cardiometabolic risk factors in Turkish children with hepatosteatosis. Turk J Pediatr. 2019;61(5):714-22.
• 4. Nobili V, Svegliati-Baroni G, Alisi A, Miele L, Valenti L, Vajro P. A 360-degree overview of paediatric NAFLD: recent insights. J Hepatol. 2013;58(6):1218-29.
• 5. Demiröz Taşolar S, Çiftçi N. Role of pan immune inflammatory value in the evaluation of hepatosteatosis in children and adolescents with obesity. J Pediatr Endocrinol Metab. 2022 ;35(12):1481-6.
• 6. Dursun F, Gerenli N, Dur SMS, et al. The relationship between vitamin D level and hepatosteatosis in obese children. North Clin Istanb. 2018;6(1):28-32.
• 7. Deurenberg P, Weststrate JA, Seidell JC. Body mass index as a measure of body fatness: age- and sex- specific prediction formulas. Br J Nutr. 1991;65(2):105-14.
• 8. Cortez-Pinto H, Camilo ME. Non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH): Diagnosis and clinical course. Best Pract Res Clin Gastroenterol. 2004;18(6):1089-104.
• 9. Feldstein AE, Charatcharoenwitthaya P, Treeprasertsuk S, et al. The natural history of non-alcoholic fatty liver disease in children: A follow-up study for up to 20 years. Gut 2009;58:1538–44.
• 10. Lee KC, Wu PS, Lin HC. Pathogenesis and treatment of non-alcoholic steatohepatitis and its fibrosis. Clin Mol Hepatol. 2023;29(1):77-98.
• 11. Cobbina E, Akhlaghi F. Non-alcoholic fatty liver disease (NAFLD) - pathogenesis, classification, and effect on drug metabolizing enzymes and transporters. Drug Metab Rev. 2017;49(2):197-211.
• 12. Liu K, Tang S, Liu C, et al. Systemic immune-inflammatory biomarkers (SII, NLR, PLR and LMR) linked to non- alcoholic fatty liver disease risk. Front Immunol. 2024;28(15):1337241.
• 13. Wang G, Zhao Y, Li Z, et al. Association between novel inflammatory markers and non-alcoholic fatty liver disease: a cross-sectional study. Eur J Gastroenterol Hepatol. 2024;36(2):203-209.
• 14. Gong H, He Q, Zhu L, et al. Associations between systemic inflammation indicators and nonalcoholic fatty liver disease: evidence from a prospective study. Front Immunol. 2024;24(15):1389967.
• 15. Duan Y, Luo J, Pan X, et al. Association between inflammatory markers and non-alcoholic fatty liver disease in obese children. Front Public Health. 2022;1(10):991393.
• 16. Cucoranu DC, Pop M, Niculescu R, et al. The Association of Nonalcoholic Fatty Liver Disease With Neutrophil- to-Lymphocyte Ratio and Neutrophil-Percentage-to-Albumin Ratio. Cureus. 2023;15(6):e41197.
• 17. Basarir G, Ozcabi B, Aksu Sayman O, et al. Evaluation of clinical, endocrine and metabolic findings in obese children with and without hepatosteatosis. J Pediatr Endocrinol Metab. 2021;34(9):1081-7.
• 18. Cho BS, Fligor SC, Fell GL, et al. A medium-chain fatty acid analogue prevents hepatosteatosis and decreases inflammatory lipid metabolites in a murine model of parenteral nutrition-induced hepatosteatosis. PLoS One. 2023;18(12):e0295244.
• 19. Lu CW, Lin MS, Lin YS, et al. Aminotransferase Ratio Is a Useful Index for Hepatosteatosis in Children and Adolescents: A Cross-Sectional Observational Study. Gastroenterol Nurs. 2019;42(6):486-95.
• 20. Gülcü Taşkın D, Kayadibi Y, Baş A, et al. Accuracy Rate of Shear Wave Elastography in Detecting the Liver Fibrosis in Overweight and Obese Children with Hepatosteatosis. Turk Arch Pediatr. 2023;58(4):436-