Association of Inflammatory and Nutritional Indices With MASLD in Adolescents: A Cross‐Sectional Study of U.S. and Chinese Populations
Congwei You, Ruli Wang, Hongmei Hou, Cai Tang, Le Zhang, Xiaodie Yao, Minkai CaoBackground
As MASLD becomes increasingly prevalent among adolescents, it is emerging as a public health concern. However, most research to date has focused on adults, and investigations in adolescents remain limited, especially regarding the role of inflammatory and nutritional indices.
Methods
Using data from the National Health and Nutrition Examination Survey (NHANES) and the Wuxi (China) cohort, we investigated the associations between inflammatory and nutritional indices and MASLD in adolescents from both the United States and China. To measure the associations of five inflammatory and nutritional indices with MASLD in adolescents, multivariate logistic regression analysis was conducted. Restricted cubic spline (RCS) models were applied to explore potential nonlinear associations between these indices and MASLD. Receiver operating characteristic (ROC) curve analysis was performed to assess predictive performance.
Results
The study included 1339 adolescents from NHANES and 582 from the Wuxi cohort, with 327 (24.4%) and 55 (9.4%) diagnosed with MASLD, respectively. Multivariate logistic regression analysis revealed that monocyte‐to‐albumin ratio (MAR), platelet‐to‐albumin ratio (PAR), leukocyte‐to‐albumin ratio (LAR), and C‐reactive protein‐to‐albumin ratio (CAR) were significantly positively associated with MASLD (all p < 0.001) in both cohorts, whereas neutrophil‐percentage‐to‐albumin ratio (NPAR) reached statistical significance only in the NHANES cohort. In addition, RCS analysis revealed significant nonlinear associations of PAR and CAR with MASLD risk in the NHANES cohort. Notably, MAR, CAR, and LAR demonstrated acceptable predictive abilities for MASLD in the adolescent population and maintained modest discriminatory performance after stratification by disease severity.
Conclusion
Our findings revealed that MAR, PAR, LAR, and CAR are strongly associated with an increased risk of MASLD in adolescents across both cohorts, while NPAR was significant only in the NHANES cohort. MAR, CAR, and LAR showed acceptable predictive performance, indicating their potential as adjunctive screening tools for early MASLD risk assessment in adolescents.