{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:51:53Z","timestamp":1791445913883,"version":"4.3.3"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"Abstract<\/jats:title>\n \n Background:<\/jats:title>\n Nonalcoholic fatty liver disease (NAFLD) is highly prevalent among patients with type 2 diabetes mellitus (T2DM).<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To determine the utility of neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and cytokeratin-18 (CK-18) (M65) in predicting T2DM patients with NAFLD.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This single-center, hospital-based, analytical, and cross-sectional study (January\u2013June 2025) enrolled adults aged 30\u201360 years with established T2DM and ultrasound-confirmed NAFLD (\n n<\/jats:italic>\n = 44) or absence of NAFLD (\n n<\/jats:italic>\n = 44).\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 88 participants (44 T2DM+NAFLD and 44 T2DM without NAFLD), patient with NAFLD has longer duration of diabetes mellitus compared to diabetes mellitus without NAFLD (10.5 \u00b1 4.2 vs. 7.8 \u00b1 3.6 years;\n P<\/jats:italic>\n = 0.002). Adiposity and blood pressure (BP) were higher (body mass inde \u00d7 29.8 \u00b1 3.3 vs. 22.9 \u00b1 1.9 kg\/m\n 2<\/jats:sup>\n ; waist 93.4 \u00b1 16.1 vs. 80.8 \u00b1 16.5 cm; systolic BP\/diastolic BP 138.9\/84.1 vs. 131.3\/74.5 mmHg; all\n P<\/jats:italic>\n < 0.001). Glycemic control was poorer (fasting blood glucose 197.7 \u00b1 53.2 vs. 171.2 \u00b1 20.7 mg\/dL;\n P<\/jats:italic>\n = 0.003; glycated hemoglobin 13.5 \u00b1 2.9 vs. 8.9% \u00b12.3%;\n P<\/jats:italic>\n < 0.001) with higher insulin. The NAFLD group also had higher aspartate transaminase\/alanine transaminase and gamma-glutamyl transferase and higher inflammation (C-reactive protein [CRP] 0.62 \u00b1 0.28 vs. 0.38 \u00b1 0.22 mg\/dL;\n P<\/jats:italic>\n < 0.001), with higher NLR and lower LMR\/PLR. CK-18 (M65) was higher (472.8 \u00b1 155.6 vs. 318.6 \u00b1 118.9 U\/L;\n P<\/jats:italic>\n < 0.001), as were fatty liver index (FLI) and aspartate aminotransferase-to-platelet ratio index (APRI). CK-18 (M65) showed excellent receiver operating characteristic performance (area under the curve [AUC] 0.955; >300 U\/L: 90.9% sensitivity, 81.8% specificity), outperforming APRI (AUC 0.816) and FLI (AUC 0.789). Lipids were atherogenic (TC 240.0 vs. 182.6; low density lipoprotein 170.4 vs. 125.0 mg\/dL;\n P<\/jats:italic>\n < 0.001). CRP AUC 0.756; NLR AUC 0.669 overall.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n CK-18 (M65) demonstrated excellent accuracy for predicting NAFLD among patients with T2DM, whereas NLR, LMR, and PLR showed only modest discriminatory performance.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aam.aam_66_26","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:00:14Z","timestamp":1791442814000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Utility of Hematologic Inflammatory Indices and Serum Cytokeratin-18 (M65) for predicting Ultrasonography-confirmed Nonalcoholic Fatty Liver Disease in Adults with Type 2 Diabetes Mellitus"],"prefix":"10.4103","author":[{"given":"Chinnathambipalayam Kandasamy","family":"Vijayasamundeeswari","sequence":"first","affiliation":[{"name":"Department of Biochemistry, Vinayaka Mission\u2019s Kirupananda Variyar Medical College and Hospital, Vinayaka Mission\u2019s Research Foundation (VMRF-DU), Salem, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Ashwini","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Vinayaka Mission\u2019s Kirupananda Variyar Medical College and Hospital, Vinayaka Mission\u2019s Research Foundation (VMRF-DU), Salem, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudha","family":"Rangasamy","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Vinayaka Mission\u2019s Kirupananda Variyar Medical College and Hospital, Vinayaka Mission\u2019s Research Foundation (VMRF-DU), Salem, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10,7]]},"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_66_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:00:14Z","timestamp":1791442814000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_66_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":0,"URL":"https:\/\/doi.org\/10.4103\/aam.aam_66_26","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"assertion":[{"value":"2026-01-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}