Korean J Obes 2012; 21(3): 166-174
Published online September 30, 2012
Copyright © Korean Society for the Study of Obesity.
Jina Yeo, Kyoung Kon Kim(1), In Cheol Hwang(1)*
Gachon University, School of Medicine, Department of Family Medicine, Gachon University Gil Hospital(1)
Background: The relationship between nonalcoholic fatty liver disease (NAFLD) and serum high sensitivity C reactive protein (hs-CRP) is not well established, and very few studies have addressed the role of serum hs-CRP as a predictor of NAFLD severity.
Methods: We examined 3,905 subjects who visited a health promotion center and were over 19 years of age. A total of 948 subjects who satisfied the NAFLD criteria were included in the final analysis. Factors associated with serum hs-CRP level or affecting body fat distribution were excluded by testing total white blood cell count, serum creatinine level, and thyroid function. The subjects were categorized into 3 groups according to the amounts of hepatic fat contents. Hepatic steatosis was assessed by ultrasonography, and the diagnosis of metabolic syndrome was made on the basis of the National Cholesterol Education Program criteria. Metabolic risk factors and hs-CRP levels were analyzed.
Results: According to the NAFLD severity, 832 subjects were categorized as normal, 92 subjects were included in the mild to moderate NAFLD group, and 24 subjects were categorized into the severe group. As the NAFLD progressed to severe, the frequencies of metabolic risk factors and elevated hs-CRP level were increased (P-trend < 0.01). In univariate analysis, most metabolic risk factors were associated with NAFLD severity in both gender but the significance for elevated blood pressure and abnormal hs-CRP level were noted inonly females. After adjusting for potential confounding variables, such as other metabolic risks and liver function test, the association with NAFLD severity and serum hs-CRP level remained significant in females and in obese group (P-trend < 0.01).
Conclusions: According to the increment of hepatic steatosis, serum hs-CRP level as well as metabolic derangement was increased with significant trend in female and obese people.
Keywords: Non-alcoholic fatty liver disease, Severity, Hs-CRP, Metabolic risk factor
Adjusted* mean hs-CRP levels according to the degree of non-alcoholic fatty liver disease in non-obese and obese group.
*Adjusted for age, sex, body mass index, smoking, alcohol, exercise, high blood pressure, elevated glucose, hypertriglyceridemia, low HDL-C, AST, ALT, and GGT.
Hs-CRP, high sensitive C reactive protein; HDL-C, high density lipoprotein cholesterol; AST, aspartate transaminase; ALT, alanine transaminase; GGT, gamma glutamyltransferase.
Gender difference in association between serum hs-crp level and NAFLD severity.
P-trend was calculated using multiple logistic regression analysis after adjusting abnormal alanine transaminase and metabolic components, such as high blood pressure, elevated fasting glucose, hypertriglyceridemia, low HDL-C, and body mass index.
Hs-CRP, high sensitive C reactive protein; HDL-C, high density lipoprotein cholesterol; NAFLD, non-alcoholic fatty liver disease.