Background and Aims: Nonalcoholic fatty liver disease (NAFLD) is a silent disease; its spectrum includes simple steatosis, nonalcoholic steatohepatitis and fibrosis. Pro- and anti-inflammatory cytokines play roles in the pathogenesis of NAFLD and insulin resistance (IR). Moreover, plasma cell antigen-1 (PC-1) is related to IR and associated with NAFLD progression. Therefore, we aimed to detect biomarkers, ultrasonographic and anthropometric findings capable of differentiating NAFLD grades, since most previous investigators were concerned more with NAFLD patients without classifying them into grades.Methods: A total of 87 NAFLD patients (31 with grade 1 (mild NAFLD), 26 with grade 2 (moderate NAFLD) and 30 with grade 3 (severe NAFLD) were included in the study, in addition to 47 controls (grade 0). All subjects underwent ultrasonographic examination for NAFLD diagnosis. Serum interleukin-10 (IL-10), plasma interleukin-18 (IL-18) and plasma PC-1 levels were determined using enzyme-linked immunosorbent assay.Results: Homoeostasis model assessment (HOMA)-IR was higher in different NAFLD grades than in controls. Ultrasonographic and anthropometric findings and lipid profile indices (except for high-density lipoprotein cholesterol, which was decreased) were increased with NAFLD progression. Grade 3 patients showed significant increase in levels of IL-18 and significant decrease in IL-10 and PC-1 levels when compared to grade 1 patients.Conclusion: Anthropometric and ultrasonographic findings were valuable in differentiating NAFLD grades. IR is very important in NAFLD pathogenesis. IL-18, HOMA-index and PC-1 levels could be used to differentiate between NAFLD grades, together with other measurements.

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Background &Aims: The clinical value of alpha-fetoprotein (AFP) as a marker to detect early hepatocellular carcinoma (HCC) has been questioned owing to its low sensitivity and specificity. The purpose of this work was to investigate whether serum Wnt/β-catenin and DKK1 levels in chronic hepatitis C patients could be used as early predictors for the risk of HCC development. Methods: The study was conducted on 37 healthy controls, and 150 CHC patients were divided into three groups: CHC, liver cirrhosis (LC), and HCC patients. AFP, AFP-L3, β-catenin, and DKK-1 were assayed by ELISA. Results: Both β-catenin and DKK1 levels significantly increased (p < 0.001) in the HCC group in comparison to LC and CHC groups. The first cut-off value for DKK-1 was 253 pg/ml with 88% sensitivity and 86% specificity. The second was 301.5 pg/ml with 82 percent sensitivity and 100% specificity. The β-catenin cut-off value was 7.35 ng/ml with 80% sensitivity and 74% specificity. A positive correlation was observed between DKK-1 and β-catenin (r=0.491), DKK-1 and tumor size (r =0.616), and β-catenin and tumor size (r =0.472). Conclusion: DKK-1 and β-catenin may serve as predictors for the progression of CHC and LC into HCC.

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