Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Front Endocrinol (Lausanne). 2021 Mar 8;12:604100. doi: 10.3389/fendo.2021.604100. eCollection 2021.
Circulating levels of interleukin (IL)-6, a well-known inflammatory cytokine, are often elevated in coronavirus disease-2019 (COVID-19). Elevated IL-6 levels are also observed in patients with metabolic dysfunction-associated fatty liver disease (MAFLD). Our study aimed to describe the association between circulating IL-6 levels and MAFLD at hospital admission with risk of severe COVID-19.
A total of 167 patients with laboratory-confirmed COVID-19 from three Chinese hospitals were enrolled. Circulating levels of IL-2, IL-4, IL-6, IL-10, tumor necrosis factor (TNF)-α, and interferon (IFN)-γ were measured at admission. All patients were screened for fatty liver by computed tomography. Forty-six patients were diagnosed as MAFLD.
Patients with MAFLD (n = 46) had higher serum IL-6 levels (median 7.1 [interquartile range, 4.3-20.0] vs. 4.8 [2.6-11.6] pg/mL, = 0.030) compared to their counterparts without MAFLD (n = 121). After adjustment for age and sex, patients with MAFLD had a ~2.6-fold higher risk of having severe COVID-19 than those without MAFLD. After adjustment for age, sex and metabolic co-morbidities, increased serum IL-6 levels remained associated with higher risk of severe COVID-19, especially among infected patients with MAFLD (adjusted-odds ratio 1.14, 95% CI 1.05-1.23; = 0.002). There was a significant interaction effect between serum IL-6 levels and MAFLD for risk of severe COVID-19 ( for interaction = 0.008).
Patients with MAFLD and elevated serum IL-6 levels at admission are at higher risk for severe illness from COVID-19.
白细胞介素（IL）-6 是一种众所周知的炎症细胞因子，其循环水平在 2019 年冠状病毒病（COVID-19）患者中常常升高。代谢功能障碍相关脂肪性肝病（MAFLD）患者也观察到升高的 IL-6 水平。本研究旨在描述入院时循环 IL-6 水平与 MAFLD 与 COVID-19 严重程度的相关性。
共纳入来自中国 3 家医院的 167 例实验室确诊的 COVID-19 患者。入院时测量循环 IL-2、IL-4、IL-6、IL-10、肿瘤坏死因子（TNF）-α 和干扰素（IFN）-γ 水平。所有患者均通过计算机断层扫描筛查脂肪肝。46 例患者被诊断为 MAFLD。
MAFLD 患者（n=46）的血清 IL-6 水平（中位数 7.1[四分位距，4.3-20.0] vs. 4.8[2.6-11.6]pg/mL， =0.030）高于无 MAFLD 的患者（n=121）。在调整年龄和性别后，MAFLD 患者患严重 COVID-19 的风险是无 MAFLD 患者的 2.6 倍左右。在调整年龄、性别和代谢合并症后，血清 IL-6 水平升高与严重 COVID-19 风险增加仍相关，尤其是在感染 MAFLD 的患者中（调整后优势比 1.14，95%置信区间 1.05-1.23； =0.002）。血清 IL-6 水平和 MAFLD 与 COVID-19 严重程度风险之间存在显著的交互作用效应（ 交互作用=0.008）。
入院时 MAFLD 合并血清 IL-6 水平升高的患者患 COVID-19 严重疾病的风险更高。
