Kumar Rahul, Porwal Y C, Dev Nishanth, Kumar Priyadarshi, Chakravarthy Sanjay, Kumawat Ashok
Department of Medicine, VMMC and Safdarjung Hospital, Delhi, India.
J Family Med Prim Care. 2020 Jan 28;9(1):390-394. doi: 10.4103/jfmpc.jfmpc_887_19. eCollection 2020 Jan.
Non-alcoholic fatty liver disease (NAFLD) is an important etiology for the development of chronic liver disease worldwide. Its pathophysiology includes chronic low-grade inflammation. There are limited studies on the association of inflammatory markers with NAFLD. Hence, in the present research, we aimed to study the association of one such inflammatory marker hs-CRP with NAFLD in north Indian population.
For this cross-sectional study, 100 subjects of either sex above 18 years of age, being diagnosed as a case of NAFLD on the basis of ultrasonography and age, sex and BMI matched subjects fulfilling the inclusion and exclusion criteria were included. Anthropometric profile, high-sensitivity C-reactive protein (hs-CRP), HbA1c, and hepatic function tests were recorded.
The baseline variables were matched for age, weight, BMI, waist-hip circumference ratio, and blood pressure. The HbA1c ( < 0.001), alanine aminotransferase ( = 0.002), alkaline phosphatase (0.002), and hs-CRP ( < 0.001) were elevated in subjects with NAFLD. The mean level of hs-CRP was significantly higher in subjects with NAFLD as compared to the control group (3.12 ± 1.42 mg/L vs 1.05 ± 0.44 mg/L, < 0.001). The mean hs-CRP level was 1.42 ± 0.55 mg/L in grade 1, 0.98 ± 0.72 mg/L in grade 2 with < 0.001, and 4.5 ± 1.11 mg/L in grade 3 with < 0.001 when compared to grade 1.The comparative value of hs-CRP in the control group was found to be 1.05 ± 0.44 mg/L. On univariate analysis waist-hip circumference ratio ( = 0.035), HbA1c ( < 0.001), and hs-CRP ( < 0.001), showed a significant association with NAFLD. On logistic regression hs-CRP was found to have significant association with NAFLD even after adjusting waist-hip circumference ratio and HbA1C (odds ratio 1.311, 95% confidence interval 1.146-1.488, < 0.001).
In this cohort of north Indian population, hs-CRP showed independent relationships with NAFLD. Thus, hs-CRP may be used as a surrogate marker for the disease severity in NAFLD.
非酒精性脂肪性肝病（NAFLD）是全球慢性肝病发展的重要病因。其病理生理学包括慢性低度炎症。关于炎症标志物与NAFLD关联的研究有限。因此，在本研究中，我们旨在研究一种这样的炎症标志物高敏C反应蛋白（hs-CRP）与印度北部人群NAFLD的关联。
对于这项横断面研究，纳入了100名18岁以上的男女受试者，他们根据超声检查被诊断为NAFLD，以及年龄、性别和BMI匹配且符合纳入和排除标准的受试者。记录人体测量指标、高敏C反应蛋白（hs-CRP）、糖化血红蛋白（HbA1c）和肝功能检查结果。
基线变量在年龄、体重、BMI、腰臀围比和血压方面相匹配。NAFLD患者的糖化血红蛋白（<0.001）、丙氨酸氨基转移酶（=0.002）、碱性磷酸酶（0.002）和hs-CRP（<0.001）升高。与对照组相比，NAFLD患者的hs-CRP平均水平显著更高（3.12±1.42mg/L对1.05±0.44mg/L，<0.001）。与1级相比，1级患者的hs-CRP平均水平为1.42±0.55mg/L，2级为0.98±0.72mg/L（<0.001），3级为4.5±1.11mg/L（<0.001）。对照组hs-CRP的比较值为1.05±0.44mg/L。单因素分析显示腰臀围比（=0.035）、糖化血红蛋白（<0.001）和hs-CRP（<0.001）与NAFLD有显著关联。逻辑回归分析发现，即使在调整腰臀围比和糖化血红蛋白后，hs-CRP与NAFLD仍有显著关联（优势比1.311，95%置信区间1.146-1.488，<0.001）。
在这个印度北部人群队列中，hs-CRP与NAFLD显示出独立关系。因此，hs-CRP可作为NAFLD疾病严重程度的替代标志物。
Zotero 插件