Junliang Zhou, Zhen Cheng, Li Sun,* Zongtao Chen* 

Health Management Center, First Affiliated Hospital of Army Medical University, Chongqing, 400038, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Zongtao Chen, Email zongtaochen@126.com Li Sun, Email 51088031@qq.com

Background and Objectives: The association between various inflammatory markers and Metabolic dysfunction associated steatotic liver disease (MASLD) and the role of lipid accumulation products in this is unclear. The aim of this study was to explore the relationship between various inflammatory markers and MASLD, and to explore the potential mediating role of LAP in inflammatory markers (WBC).
Methods: The binary logistic regression model was used to evaluate the correlation between various inflammatory markers and MASLD. We used the Restricted Cubic Spline (RCS) to describe the measurement-response relationship between these factors and MASLD. In addition, we assessed whether lipid accumulation products have a mediating role in the association by intermediary analysis, which was verified by the Bootstrapping method.
Results: From 2021 to 2023, a total of 13,628 participants’ testing data were collected and used from the Health Management Center of Southwest Hospital (SWH), including 10,988 non-MASLD and 2,640 MASLD. The results of independent sample T-test showed that inflammation-related markers such as PLT, WBC, SII, NLR, and PLR were significantly different between the control group (Non-MASLD) and the experimental group (MASLD), and WBC was particularly prominent. The results of binary logistic regression analysis showed that there was a close positive correlation between WBC and MASLD after adjusting for various confounding factors such as age, sex, BMI, and smoking status (OR = 1.255, 95% confidence interval: 1.135– 1.388), p < 0.001. The RCS results once again demonstrated a linear dose-response relationship between WBC and MASLD risk. Finally, the results of mediation analysis and bootstrapping validation showed that LAP partially mediated the association between inflammatory marker (WBC) and MASLD, and its effect percentage was 13.58%.
Conclusion: The results of this study suggest that the inflammatory marker WBC is positively correlated with the risk of MASLD, and LAP plays a partial mediating role in this association.

Keywords: inflammatory markers, mediation analysis, RCS, LAP, MASLD