Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease with a high incidence worldwide, and its incidence is increasing year by year. Plasma atherogenic Index (AIP) is used to assess the risk of cardiovascular disease and metabolic dysfunction, and albumin to glutamyltransferase ratio (AGR) is often used to assess liver function, nutritional status, and immune system diseases. This study aimed to assess the association of AIP, AGR and non-alcoholic fatty liver disease and to establish a practical and cost-effective prediction model.

Using data from the National Health and Nutrition Examination Survey (NHANES) from March 2017 to March 2020, residents 18 years of age and older with complete demographic, laboratory, and instantaneous elastography test data were included. SPSS 27.0 and R 4.4.0 were used to analyze the data, single-factor Logistic regression analysis was applied to screen the influencing factors of NAFLD, stepwise regression was applied to screen the variables, and multi-factor Logistic regression was performed to construct the prediction model and draw the column graph.

AIP (OR = 3.549, 95% CI: 1.876-6.712) was a risk factor for NAFLD, and AGR (OR = 0.782, 95% CI: 0.655-0.934) was a protective factor for NAFLD. The calibration curve of NAFLD was stable, and the ROC curve AUC was 0.859.

AIP is an independent risk factor for NFLAD. AGR is an independent protective factor for NAFLD