Neutrophil to lymphocyte ratio as a reliable marker to predict insulin resistance and fibrosis stage in chronic hepatitis C virus infection.

Hepatitis C virus (HCV) is one of the most noxious infectious diseases. Chronic hepatitis C (CHC) had biochemical evidence of insulin resistance (IR). The neutrophil/lymphocyte ratio (NLR) integrates information on the inflammatory milieu and physiological stress.We aimed to investigate the clinical utility of NLR to predict the presence of IR and fibrosis in CHCvirus infection.The study included 234 CHC patients and 50 healthy controls. The CHC group was divided into two subgroups ; CHC with HOMA-IR>3 and CHC with HOMA-IR≤3. Liver biopsy, homeostasis model assessment-IR (HOMA-IR), neutrophil and lymphocyte counts were recorded ; and NLR was calculated. Proinflammatory cytokines [tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6)] were measured by an enzyme-linked immunosorbent assay.Patients with HOMA-IR>3 had a higher NLR compared with patients with HOMA-IR≤3 [2.61±0.95 and 1.92±0.86, respectively, P 3 and advanced fibrosis. This ratio can be used as a novel noninvasive marker to predict IR and advanced disease.