Inflammatory biomarkers in alcohol use disorder: neutrophil/lymphocyte and monocyte/HDL-C ratios as potential diagnostic indicators.

Background: Alcohol use disorder (AUD) constitutes a major global public health concern due to its widespread biological, psychological, and social consequences. Although several biochemical markers-such as gamma-glutamyl transferase (GGT), carbohydrate-deficient transferrin (CDT), and mean corpuscular volume (MCV)-have been proposed for AUD diagnosis, their limited specificity can lead to diagnostic inaccuracies. This study investigates the relationship between AUD and novel inflammatory markers, including the monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-HDL cholesterol ratio (NHR), and monocyte-to-HDL cholesterol ratio (MHR).

Methods: This cross-sectional case-control study included 84 patients with clinically diagnosed AUD and 50 healthy controls (HC). The AUD group was subdivided into two categories: those with elevated liver enzyme levels (E-AUD) and those with normal liver function (NE-AUD). All participants underwent complete blood count and HDL-C measurement. Based on these values, NLR, MLR, NHR, and MHR were calculated. Statistical analysis was performed using one-way ANOVA and Kruskal-Wallis tests with SPSS version 25.0.

Results: No significant differences were observed in neutrophil, monocyte, HDL-C, NLR, MHR, and NHR levels among the three groups (p > 0.05). However, HDL-C and NLR levels were significantly higher in the E-AUD group compared to controls. In the NE-AUD group, neutrophil, monocyte, and MHR levels were significantly elevated, despite normal liver enzyme profiles. These findings indicate early inflammatory activation in AUD patients without biochemical evidence of liver dysfunction.

Conclusions: Neutrophil, monocyte, HDL-C, NLR, and MHR levels differ between individuals with AUD and healthy subjects. The elevated inflammatory markers in the NE-AUD group suggest their potential utility in early AUD detection. In contrast, increased HDL-C and NLR in the E-AUD group may reflect advanced disease. Further prospective studies are needed to validate these findings.