Non-alcoholic fatty liver disease, common in Nobesity, is characterised by fatty infiltration to the liver and can progress to steatohepatitis. Inflammation is a predictor of metabolic disease, but the relationship between inflammation and liver disease is unclear. This study determines whether liver function enzymes are associated with markers of systemic inflammation. In a group of 249 overweight women, fasting blood samples were collected and analysed for insulin, glucose, lipids, C-reactive protein (CRP), sialic acid (SA), alanine aminotransferase, alkaline phosphatase (ALP) and γ-glutamyltransferase.
SA and CRP were significant predictors of ALP concentrations, independent of metabolic syndrome features (β=0.35, p<0.0001 and β=0.20, p=0.004). SA and CRP showed significant incremental increases across groups based on the number of features of metabolic disease, which persisted after adjustement for body mass index (β=0.32, p<0.0001 and =0.16, p=0.02). These data suggest that systemic inflammation is significantly associated with liver function markers, Independent of other metabolic risk factors.
Marchesini G. , Brizi M., Bianchi G. et al. Non-alcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes2001;50:1844-50.
2.
Ryan MC, Wilson AM, Slavin J., Best JD, Jenkins AJ, Desmond PVAssociations between liver histology and severity of the metabolic syndrome in subjects with non-alcoholic fatty liver disease. Diabetes Care2005;28:1222-4.
3.
Marchesini G. , Brizi M., Morselli-Labate AM et al. Association of nonalcoholic fatty liver disease with insulin resistance. Am J Med1999;107:450-5.
4.
Clark JM, Brancati FL, Diehl AMThe prevalence and etiology of elevated aminotransferase levels in the United States. Am J Gastroenterol2003 ;98:960-7.
5.
Angulo P.Nonalcoholic fatty liver disease. N Engl J Med2002;346:1221-31.
6.
Browning LM, Jebb SA, Mishra GD et al. Elevated sialic acid, but not CRP, predicts features of the metabolic syndrome independently of BMI in women. Int J Obes2004;28:1004-10.
7.
Ridker PM, Hennekens CH, Burling JE, Rifai N.C-Reactive protein and other markers of inflammation in the prediciton of cardiovascular disease in women. N Engl J Med2000;342:836-43.
8.
Haverkate F. , Thompson SG, Pyke SD, Gallimore JR, Pepys MBProduction of C-reactive protein and risk of coronary events in stable and unstable of C-reative protein and risk of coronary events in stable and unstable angina. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group [see comments] . Lancet1997;349:462-6. 9. Freeman DJ, Norrie J., Caslake MJ et al. C-reactive protein is an independent predictor of risk for the development of diabetes in the West of Scotland Coronary Prevention Study. Diabetes2002;51:1596-600. 10. Pradhan AD, Manson JE, Rifai N., Buring JE, Ridker PMC-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA2001;286:327-34.
9.
Festa A., D'Agostino R. Jr., Tracy RP, Haffner SMElevated levels of acutephase proteins and plasminogen activator inhibitor-1 predict the development of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes2002;51:1131-7.
10.
WHO.Report of a WHO Consultation, Part 1: Diagnosis and Classification of Diabetes Mellitus. Geneva: World Health Organisation, 1999:WHO/NCD/ NCS/99.2.
11.
Nannipieri M., Gonzales C., Baldi S. et al. Liver enzymes, the metabolic syndrome, and incident diabetes: the Mexico City diabetes study . Diabetes Care2005;28:1757-62.
12.
Hanley AJ, Williams K., Festa A. et al. Elevations in markers of liver injury and risk of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes2004;53:2623-32.
13.
James O., Day C.Non-alcoholic steatohepatitis: another disease of affluence. Lancet1999;353:1634-6.
14.
Ong JP, Elariny H., Collantes R. et al. Predictors of nonalcoholic steatohepatitis and advanced fibrosis in morbidly obese patients. Obes Surg2005 ;15:310-15.
