Associations between Systemic Inflammatory Biomarkers and Metabolic Dysfunction Associated Steatotic Liver Disease: Findings from NHANES

Abstract Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) represents the most prevalent form of chronic liver disease and can progress to cirrhosis and hepatocellular carcinoma (HCC). While systemic inflammatory biomarkers have been linked to various liver diseases, their roles in MASLD remain uncertain. 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. The study incorporated 10 inflammatory biomarkers, including ALI, SIRI, SII, SIPS, IBI, NLR, PLR, CAR, LMR, and PNI. Logistic regression, RCS regression, segmented regression, and subgroup analyses were implemented to explore the relationship between systemic inflammatory biomarkers and MASLD. After adjusting for vital confounders, half of the examined markers exhibited a significant association with MASLD, especially ALI, IBI, PLR, and CAR (P < 0.001). Most of these systemic inflammatory biomarkers, including ALI, SIRI, IBI, CAR, LMR, and PNI, demonstrated an obvious non-linear correlation with MASLD (P < 0.05). Moreover, the majority of these markers (SIRI, SII, IBI, NLR, PLR, and PNI) displayed notable variations in their associations with MASLD among various BMI categories (P < 0.05). In conclusion, systemic inflammatory biomarkers demonstrated a significant association with MASLD risk. Further large-scale prospective studies may be warranted to validate this relationship.