Nutritional Indices and Inflammatory Markers in MASLD

Overview

Metabolic Dysfunction-Associated steatotic Liver Diseases MASLD affects approximately 25 percent of population. Systemic inflammation plays role in MASLD progression. This cross-sectional observational study at Assiut University Hospitals will include 180 participants aged 18 to 65 years divided into 90 with MASLD and 90 without MASLD over one year. Nutritional indices Prognostic Nutritional Index PNI and Controlling Nutritional Status CONUT score will be calculated from albumin lymphocyte count and cholesterol. CBC-based inflammatory indices SIRI SII PIV PWR PLR MPR WNR NLR will be calculated. MASLD fibrosis score based on age BMI diabetes AST ALT ratio platelet albumin and FibroScan will assess fibrosis F0-F2 versus F3-F4. Aim to evaluate correlation between PNI CONUT and MASLD and role of inflammatory indices as predictors for MASLD and advanced fibrosis.

MASLD has become global health problem 25 percent prevalence. Previous studies show relationship between MASLD and nutrition. Systemic inflammation is key link between metabolic dysregulation and hepatic fibrogenesis. Indices like SII SIRI PLR integrate neutrophil lymphocyte monocyte platelet counts reflecting immune-nutritional balance. PNI defined by lymphocytes and albumin linking immune competence with nutrition. CONUT reflects nutrition inflammation by albumin total cholesterol lymphocyte count. This cross-sectional study will include patients 18-65 years at Assiut University Hospitals. Group 1 MASLD group 90 patients, Group 2 control non-MASLD 90 participants. Inclusion: 18-65 years. Exclusion: acute infection, major surgeries or trauma within last 6 months, known malignancy, previous bariatric surgery, liver cirrhosis. Sample size 180 calculated by G\*Power version 3.1.9.7 correlation r 0.22 alpha 0.05 power 80 percent plus 10 percent dropout. Study tools: medical history clinical examination anthropometric measurements weight height waist hip mid arm circumference BMI weight kg per height m2 WHO categories. MASLD fibrosis score: age BMI IFG diabetes AST ALT ratio platelet albumin cutoff less than -1.455 absence F0-F2 negative predictive 93 percent, -1.455 to 0.675 indeterminate, greater than 0.676 presence F3-F4 positive predictive 90 percent. FibroScan non-invasive ultrasound for fibrosis. Labs: CBC urea creatinine lipid profile LFTs. Indices: SIRI neutrophil x monocyte divided by lymphocyte, SII platelet x neutrophil divided by lymphocyte, PIV neutrophil x monocyte x platelet divided by lymphocyte, PWR platelet divided by WBC, PLR platelet divided by lymphocyte, platelet albumin ratio, MPR monocyte divided by platelet, WNR WBC divided by neutrophil, NLR neutrophil divided by lymphocyte. Analysis by SPSS version 22 Kolmogorov-Smirnov normality Chi-square t-test Mann Whitney p less than 0.05.