Association of C-reactive protein with histological, elastographic, and sonographic indices of non-alcoholic fatty liver disease in individuals with severe obesity

Abstract

Background Inflammation is critical in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). hs-CRP, an inflammatory marker, is considered one of the prognostic predictors of hepatic damage progression in NAFLD in some studies. Methods We assessed the concordance of hs-CRP concentrations and liver steatosis, steatohepatitis, and fibrosis based on elastography, sonography and liver biopsy findings in patients with severe obesity undergoing bariatric surgery. Results Among 90 patients, 56.7% showed steatohepatitis and 8.9% severe fibrosis. Hs-CRP were significantly associated with liver histology in an adjusted regression model (OR 1.155, 95% CI 1.029–1.297, p = 0.014; OR 1.155, 1.029–1.297, p = 0.014; OR 1.130, 1.017–1.257, p = 0.024 for steatosis, steatohepatitis, and fibrosis, respectively). The ROC curve, a cutoff of hs-CRP = 7 mg/L, showed a reasonable specificity (76%) for detecting biopsy-proven fibrosis and steatosis. Conclusion hs-CRP was associated with any degree of histologically diagnosed liver damage, and it had a reasonable specificity for predicting biopsy-proven steatosis and fibrosis in obese individuals. Further studies are needed to identify non-invasive biomarkers that could predict NALFD progression due to the relevant health risks linked to liver fibrosis.

Association between non-alcoholic fatty liver disease and risk of sarcopenia: a systematic review and meta-analysis

“…Under the obese state, impaired insulin signalling transduction by inflammatory cytokines increases the levels of plasma-free fatty acid, leading to lipid accumulation in the liver and muscles. 40 Insulin resistance indirectly affects hepatic glucose and lipid metabolism by increasing substrates that promote lipogenesis and gluconeogenesis (such as glucose, fatty acids and glycerol). 41 Since insulin maintains muscle mass through activation of the mammalian target of rapamycin (mTOR) and plays a role in skeletal muscle anabolism, insulin resistance in skeletal muscle leads to increased muscle degradation and decreased mitochondrial content and oxidative capacity in muscle cells.…”