AISI and MASLD: a nonlinear association in U.S. adults (NHANES 2017-2020)

Abstract Background Systemic inflammation is recognized as a key driver in the development of metabolic dysfunction-associated steatotic liver disease (MASLD). While emerging evidence suggests that the Aggregate Index of Systemic Inflammation (AISI) may reflect overall inflammatory burden, its assoc...

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Main Authors: Xue Xiao, Guanhong Li, Yan Ma, Yanfang Chen
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Gastroenterology
Subjects:
Online Access:https://doi.org/10.1186/s12876-025-04210-5
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author Xue Xiao
Guanhong Li
Yan Ma
Yanfang Chen
author_facet Xue Xiao
Guanhong Li
Yan Ma
Yanfang Chen
author_sort Xue Xiao
collection DOAJ
description Abstract Background Systemic inflammation is recognized as a key driver in the development of metabolic dysfunction-associated steatotic liver disease (MASLD). While emerging evidence suggests that the Aggregate Index of Systemic Inflammation (AISI) may reflect overall inflammatory burden, its association with MASLD prevalence remains poorly understood, especially in large population-based studies. Methods This is a population-based, cross-sectional study analyzed NHANES data (2017-2020) from 5,948 U.S. adults aged $$\ge $$ 20 years, including both sexes and diverse ethnicities. We aimed to assess the association between the Aggregate Index of Systemic Inflammation (AISI) and MASLD prevalence. MASLD was defined by a controlled attenuation parameter (CAP) $$\ge $$ 274 dB/m, and participants with viral hepatitis or excessive alcohol intake were excluded. AISI was calculated from neutrophil, monocyte, platelet, and lymphocyte counts. We used adjusted analysis models to evaluate the association, adjusting for demographic and clinical covariates. Subgroup and sensitivity analyses were conducted to test the robustness of our findings. Results Our research identified a significant association between AISI and MASLD prevalence. After adjusting for confounders, individuals in the highest AISI quartile had a 53% higher risk of MASLD (OR = 1.53; 95% CI: 1.14-2.06; P for trend < 0.001). A nonlinear relationship was observed, with an inflection point at $$\log _2$$ AISI = 8.552. Conclusion AISI is independently associated with MASLD prevalence in U.S. adults and may serve as an accessible biomarker for MASLD risk stratification in primary care settings.
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spelling doaj-art-3e59c5248f7f4b3ba6ce0ba97c31e6ad2025-08-20T03:46:03ZengBMCBMC Gastroenterology1471-230X2025-08-0125111110.1186/s12876-025-04210-5AISI and MASLD: a nonlinear association in U.S. adults (NHANES 2017-2020)Xue Xiao0Guanhong Li1Yan Ma2Yanfang Chen3Department of Gastroenterology, The First Affiliated Hospital, Jinan UniversityDepartment of Gastroenterology, The First Affiliated Hospital, Jinan UniversityDepartment of Gastroenterology, The First Affiliated Hospital, Jinan UniversityDepartment of Gastroenterology, The First Affiliated Hospital, Jinan UniversityAbstract Background Systemic inflammation is recognized as a key driver in the development of metabolic dysfunction-associated steatotic liver disease (MASLD). While emerging evidence suggests that the Aggregate Index of Systemic Inflammation (AISI) may reflect overall inflammatory burden, its association with MASLD prevalence remains poorly understood, especially in large population-based studies. Methods This is a population-based, cross-sectional study analyzed NHANES data (2017-2020) from 5,948 U.S. adults aged $$\ge $$ 20 years, including both sexes and diverse ethnicities. We aimed to assess the association between the Aggregate Index of Systemic Inflammation (AISI) and MASLD prevalence. MASLD was defined by a controlled attenuation parameter (CAP) $$\ge $$ 274 dB/m, and participants with viral hepatitis or excessive alcohol intake were excluded. AISI was calculated from neutrophil, monocyte, platelet, and lymphocyte counts. We used adjusted analysis models to evaluate the association, adjusting for demographic and clinical covariates. Subgroup and sensitivity analyses were conducted to test the robustness of our findings. Results Our research identified a significant association between AISI and MASLD prevalence. After adjusting for confounders, individuals in the highest AISI quartile had a 53% higher risk of MASLD (OR = 1.53; 95% CI: 1.14-2.06; P for trend < 0.001). A nonlinear relationship was observed, with an inflection point at $$\log _2$$ AISI = 8.552. Conclusion AISI is independently associated with MASLD prevalence in U.S. adults and may serve as an accessible biomarker for MASLD risk stratification in primary care settings.https://doi.org/10.1186/s12876-025-04210-5AISIsystemic inflammationMASLDNHANESInflammatory biomarkers
spellingShingle Xue Xiao
Guanhong Li
Yan Ma
Yanfang Chen
AISI and MASLD: a nonlinear association in U.S. adults (NHANES 2017-2020)
BMC Gastroenterology
AISI
systemic inflammation
MASLD
NHANES
Inflammatory biomarkers
title AISI and MASLD: a nonlinear association in U.S. adults (NHANES 2017-2020)
title_full AISI and MASLD: a nonlinear association in U.S. adults (NHANES 2017-2020)
title_fullStr AISI and MASLD: a nonlinear association in U.S. adults (NHANES 2017-2020)
title_full_unstemmed AISI and MASLD: a nonlinear association in U.S. adults (NHANES 2017-2020)
title_short AISI and MASLD: a nonlinear association in U.S. adults (NHANES 2017-2020)
title_sort aisi and masld a nonlinear association in u s adults nhanes 2017 2020
topic AISI
systemic inflammation
MASLD
NHANES
Inflammatory biomarkers
url https://doi.org/10.1186/s12876-025-04210-5
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AT guanhongli aisiandmasldanonlinearassociationinusadultsnhanes20172020
AT yanma aisiandmasldanonlinearassociationinusadultsnhanes20172020
AT yanfangchen aisiandmasldanonlinearassociationinusadultsnhanes20172020