the impact of monocyte to HDL cholesterol ratio trajectories on the incidence of non-alcoholic fatty liver disease: two cross section studies and a cohort study.

Objective the new inflammation biomarkers has been enrolled to predict risk of several chronic diseases. However, research on biomarkers related to Non-Alcoholic Fatty Liver Disease (NAFLD) wasn’t deep. We aimed to identify the inflammation index most closely associated with NAFLD, explore its trajectory in relation to NAFLD events Methods Firstly, through 29123 domestic and 6331 international cross-sectional samples, we utilized random forest analysis to screen out the most potent inflammatory factors associated with NAFLD prevalence. Secondly, through 8524 domestic cohort samples, we utilized Group-based Trajectory Modeling (GBTM) to identify the key inflammatory factor (changes) trajectories. Furtherly, we utilized random survival forest analysis to rank the importance of key inflammatory factor-related trajectories and baseline. And then, we utilized the Cox proportional hazard model to assess the MHR-related trajectory's risk of NAFLD incidence. Finally, we conducted subgroup analysis and interaction analysis. Results The prevalence of NAFLD in domestic and international cross-sectional data was 30% and 20% respectively. Random (survival) forest analysis revealed that MHR is the most significant contributor among the five inflammatory factors to the prevalence of NAFLD, and the MHR trajectory is the most prominent indicator among the three MHR-related factors in terms of its contribution to the incidence of NAFLD, in the Chinese cohort. The incidence of new-onset NAFLD gradually increased with the elevation of MHR trajectory (P < 0.05). MHR trajectory had an additive interaction with BMI on the incidence of NAFLD. Conclusion A higher MHR trajectory was significantly associated with an increased risk of NAFLD incidence, suggesting that monitoring MHR trajectory over time may aid in identifying pre-NAFLD and NAFLD, particularly in overweight and obese men.