White blood cell count to platelet ratio (WBC/PLT) is associated with adverse lipid parameters and lower antioxidants intake in patients with NAFLD

Abstract

Non-alcoholic fatty liver disease (NAFLD) is strongly linked to systemic low-grade inflammation and adverse dietary exposures. Hematologic indices derived from routine blood counts have emerged as accessible indicators of inflammatory and metabolic imbalance. The white blood cell-to-platelet (WBC/PLT) ratio may reflect immune activation in the context of metabolic liver disease; however, data regarding its association with dietary composition and cardiometabolic markers remain limited. This study aimed to examine whether the WBC/PLT ratio is associated with lipid disturbances and dietary components in adults diagnosed with NAFLD. In a cross-sectional analysis of 256 individuals with NAFLD attending a tertiary referral center, participants were stratified into tertiles according to WBC/PLT values. Anthropometric measurements, biochemical profiles, and complete blood counts were obtained using standardized procedures. Habitual dietary intake was evaluated through a validated food frequency questionnaire. Intergroup comparisons were performed using one-way ANOVA, and generalized linear models were applied to adjust for potential confounders including age, sex, body mass index, total energy intake, smoking status, and physical activity. General demographic and anthropometric variables did not differ significantly across tertiles. However, participants in the highest WBC/PLT tertile exhibited significantly elevated triglyceride (TG) concentrations and reduced high density lipoprotein cholesterol (HDL-C) levels after multivariable adjustment. Higher WBC/PLT values were also associated with lower consumption of vitamins C and E. A progressive rise in leukocyte count accompanied by a decline in platelet count was observed across increasing tertiles (P < 0.001 for both). An elevated WBC/PLT ratio is linked to an unfavorable lipid profile and suboptimal dietary components characterized by low antioxidant intake in individuals with NAFLD. These findings suggest that WBC/PLT may serve as a simple, non-invasive indicator of inflammation-related metabolic risk, potentially influenced by dietary quality.