S1197 Diagnostic Accuracy of Neutrophils to Lymphocytes Ratio in Predicting Non Alcoholic Fatty Liver Disease in Helicobacter pylori Positive Patients

Abstract

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a multifactorial disorder and most frequently associated to obesity, diabetes mellitus, dyslipidemia and metabolic syndrome. Recently, there has been a special focus on role of Helicobacter Pylori (HP) in development of NAFLD, non-alcoholic steatohepatitis (NASH) and liver cirrhosis. Moreover, the pathogenesis of HP with NAFLD is not clearly defined. We aimed to determine the diagnostic accuracy of Neutrophils to Lymphocytes ratio (NLR) in predicting NAFLD in helicobacter pylori infected patients. Methods: All patients with H.pylori infection were enrolled in the study. A fasting percutaneous abdominal ultrasound was performed in all the patients. Baseline neutrophil and lymphocyte count per microliter were evaluated from complete blood count and ratio was calculated. All the data was entered and analyzed by Statistical Package for the Social Sciences (SPSS) version 20.0. Area under the curve (AUC), sensitivity, specificity, positive predictive value, negative predictive value for the cut-offs of NLR were calculated. Results: In 98 patients; 52 (53.1%) are females with mean age of 38.3 ± 11.7 years. At presentation, 63(64.2%) patients had dyspeptic symptoms for more than 2 months. Comorbidities like diabetes was seen in 14 (14.2 %) and hypertension in 8 (8.16%) patients respectively. On ultrasound, fatty liver was seen in 76 (77.6%) patients. Mean neutrophil count was statistically significantly higher (59.9 vs 54, p = 0.09) while mean lymphocyte was lower in fatty liver group as compared to without (27.3 vs 32.8, p = 0.02). NLR was statistically significantly raised in patients with fatty liver disease (3.2 vs 1.9, p = 0.04). AUC of NLR score was 0.70. At a cut off of 1.69, the sensitivity, specificity, NPV and PPV were 82.89%, 40.91%, 82.89% and 40.91% respectively for NLR with diagnostic accuracy of 73.47% in predicting fatty liver disease in H. Pylori positive patients. Conclusion: Neutrophil to lymphocyte ratio is a sensitive in predicting fatty liver disease in patients with helicobacter pylori infection.