2. Angulo P et al. The NAFLD fibrosis score: a non-invasive system that identifies liver fibrosis in patients with NAFLD. Hepatology 2007;45:846–854. M VEYSEY,1,2,3 W SIOW,1,2 S NIBLETT,2,3 K KING,2,3 Z YATES,4 M LUCOCK5 1Department of Gastroenterology and 2Teaching & Research Unit, Central Coast Local Health District and the 3Schools of Medicine & Public Health, 4Biomedical Sciences and 5Environmental & Life Sciences, University of Newcastle, NSW, Australia Introduction: An elevated white cell count is associated with both metabolic syndrome and insulin resistance, with non-alcoholic fatty liver disease (NAFLD) being considered the hepatic manifestation of metabolic

syndrome. There are limited data suggesting an association between raised peripheral white cell counts and NAFLD. The fatty liver index (FLI)1 is a validated, non-invasive method of estimating the VX809 likelihood of NAFLD in individuals and is calculated using

an algorithm that incorporates 4 parameters: BMI, waist circumference, GGT and triglyceride levels. We, therefore, set out to examine the relationship between NAFLD, defined as an FLI≥60, and peripheral white cell counts. Methods: We used a prospectively recruited population of 440 community-based participants, aged over 65 (mean age 78 yr, 264 females), who completed a comprehensive assessment of their medical history, metabolic risk factors, medications Tyrosine Kinase Inhibitor Library datasheet and alcohol intake. Patients with other liver disease or alcohol intake >20.5 g/day were excluded. All subjects had their FLIs calculated and were classified into three groups, FLI < 30 (No NAFLD), 30

≤ FLI < 60 (Borderline) and FLI ≥ 60 (NAFLD). White cell counts and differentials were measured in peripheral blood collected at the time of FLI estimation. Results: No NAFLD NAFLD p value n = 122 N = 190 White cell count (109/l) 5.89 ± 1.64 6.83 ± 1.66 medchemexpress <0.001 Neutrophils (109/l) 3.47 ± 1.29 4.03 ± 1.19 <0.001 Lymphocytes (109/l) 1.69 ± 0.67 1.97 ± 0.81 <0.01 Monocytes (109/l) 0.51 ± 0.17 0.56 ± 0.17 <0.01 Eosinophils (109/l) 0.19 ± 0.16 0.23 ± 0.16 <0.05 Basophils (109/l) 0.02 ± 0.04 0.02 ± 0.05 ns For the whole cohort, there were weak but significant linear relationships between FLI and white cell count (r = 0.25, p < 0.001), neutrophils (r = 0.20, p < 0.001), lymphocytes (r = 0.17, p < 0.001), monocytes (r = 0.15, p < 0.01) and eosinophils (r = 0.12, p < 0.05). Furthermore, there was a linear relationship between FLI and CRP (r = 0.14, p < 0.01), supporting the inflammatory nature of NAFLD. Conclusion: This study confirms that NAFLD is associated with elevation of peripheral white cell counts and supports the inflammatory nature of NAFLD. That all sub-types of white cell, except basophils, are elevated in NAFLD suggests that the inflammatory process may be multifactorial. 1. Koehler E et al. External Validation of the Fatty Liver Index for Identifying Non-alcoholic Fatty Liver Disease in a Population-based Study.