Prognostic impact of systemic inflammation indicators on all-cause and CVD mortality in adults with MASLD.

Background: Inflammation plays a key role in the onset of MASLD, progression to MASH, and is associated with poor prognosis of MASLD. The aim of this study was to thoroughly investigate the association of different systemic inflammatory indicators with all-cause mortality and CVD mortality outcome in MASLD.

Methods: Data were from the NHANES cohort. Mortality data were from the NDI. Systemic inflammatory indicators analyzed included lymphocytes, monocytes, neutrophils, platelets, CRP, MLR, NLR, and PLR. Associations of inflammatory indicators with mortality were analyzed using Kaplan-Meier curves, Cox regression, and restricted cubic spline analysis. Time-dependent ROC curve was performed to analysis the predictive value of inflammatory indicators for mortality.

Results: 10,308 MASLD adults were included. Systemic inflammatory markers were associated with mortality outcome in MASLD. Specifically, lymphocyte and platelet count showed an L-shaped association with all-cause mortality in MASLD patients, monocyte and neutrophil count and CRP level demonstrated a positive nonlinear correlation, NLR and MLR presented a linear positive correlation, and PLR presented a U-shaped association (all P < 0.001). Time-dependent ROC curve analysis showed that NLR and MLR exhibited higher predictive values among all these markers for mortality in MASLD adults.

Conclusions: Systemic inflammatory indicators were associated with mortality outcome in MASLD and may serve as valuable prognostic biomarkers for MASLD.