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We aimed to evaluate the relationship between the white blood cell count-to-mean platelet volume ratio (WBC\/MPV), platelet-to-lymphocyte count ratio (PLR) and lymphocyte-monocyte ratio (LMR) in association with NAFLD, considering the presence of obesity and MS. Additionally, we aimed to investigate whether these parameters exhibited similar correlations in metabolic dysfunction-associated steatotic liver disease (MASLD) as observed in NAFLD. This cross-sectional study included subjects who underwent a comprehensive health evaluation, including blood tests and abdominal ultrasonography. Subgroup analyses were conducted based on obesity and MS. Out of a total 5929 subjects (3271 males, mean age 49.7\u2009\u00b1\u200910.6\u00a0years), 2253 (38.0%) had NAFLD. WBC\/MPV was significantly higher, and PLR was significantly lower in subjects with NAFLD. In the analysis restricted to the nonobese (BMI\u2009&lt;\u200925\u00a0kg\/m<jats:sup>2<\/jats:sup>) population without MS, both WBC\/MPV and PLR were independently associated with NAFLD: WBC\/MPV (adjusted OR 3.366; 95% CI 2.238\u20135.066) and PLR (adjusted OR 0.997; 95% CI 0.996\u20130.999). When assessing the risk of NAFLD based on the WBC\/MPV and PLR quartiles, the adjusted OR and 95% CI for the lowest quartile compared to the highest were 2.055 (95% CI 1.626\u20132.602) for WBC\/MPV and 0.660 (95% CI 0.523\u20130.832) for PLR in the nonobese, metabolically healthy group. The levels of WBC\/MPV and PLR were independently associated with NAFLD. Furthermore, in MASLD, an association with WBC\/MPV, PLR and LMR was identified, similar to the results observed in NAFLD, even after adjusting for confounding variables. In conclusion, the present study demonstrated a significant association between NAFLD and platelet-related parameters, especially in nonobese, metabolically healthy subjects.<\/jats:p>","DOI":"10.1038\/s41598-024-56796-7","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T13:02:36Z","timestamp":1710334956000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The association between platelet-related parameters and nonalcoholic fatty liver disease in a metabolically healthy nonobese population"],"prefix":"10.1038","volume":"14","author":[{"given":"Eun Kyung","family":"Choe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hae Yeon","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"issue":"Suppl 1","key":"56796_CR1","first-page":"S5","volume":"40","author":"JM Clark","year":"2006","unstructured":"Clark, J. 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