1PNPLA3 and Neutophil Lymphocyte Ratio as a Genetic and Inflammatory Predictors of Histopathological Severity by Liver Biopsy in Nonalcoholic Fatty Liver Disease

Abstract Background Nonalcoholic fatty liver disease (NAFLD) is a common chronic liver condition characterized by fat accumulation in the liver, which can lead to inflammation and scarring, resulting in irreversible liver damage. NAFLD is often associated with other metabolic comorbidities and is considered the hepatic manifestation of metabolic syndrome. In addition to liver-related morbidity and mortality, NAFLD is also associated with cardiovascular disease (CVD). Aim of the Work The aim of the study is to determine the relation between genetic and inflammatory markers in one side to the degree of histopathological changes by liver biopsy in patients with NAFLD on the other side. Patients and Methods This study was conducted on 20 patients who were candidate for bariatric surgery with fatty liver in abdominal ultrasonography and from donors for liver transplantation from internal medicine and surgical department in Ain Shams University hospitals and 10 healthy persons who were donors for liver transplantation as control group. Results The study found that neutrophil lymphocyte ratio (N/L ratio) and mean platelet volume (MPV) were significantly different between NAFLD patients and the control group. Additionally, the distribution of the PNPLA3 gene variant (rs738409 C/G) was significantly different between NAFLD patients and the control group, with most NAFLD patients having the homozygous GG variant. The study also found a significant difference between the PNPLA3 gene variant and steatosis percentage in NAFLD patients. However, there was no significant difference between the PNPLA3 gene variant and other clinical markers, including hepatic cell ballooning, fibrosis, glycemic status, liver enzymes, lipid profile, N/L ratio, or MPV. Conclusion NAFLD is more common in subjects with Homozygous GG variant of PNPLA3 gene. NAFLD patients with Homozygous GG variant of PNPLA3 gene are more prone to high grade of steatosis. Liver cell ballooning and liver fibrosis have no relation with different variants of PNPLA3 gene. Neutrophil to lymphocyte ratio (N/L ratio) and mean platlet volume (MPV) are good inflammatory markers to detect NAFLD.