Inflammatory Markers in Relation to Nonalcoholic Fatty Liver Disease in Urban South Indians

Gokulakrishnan, Kuppan; Anjana, Ranjit Mohan; Deepa, Mohan; Prabu, Paramasivam; Chandrakumar, Sathishkumar; Velmurugan, Kaliyaperumal; Mohan, Viswanathan

doi:10.1089/dia.2011.0213

Cited by 23 publications

(14 citation statements)

References 31 publications

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“…Previous studies have demonstrated an association between WBC counts and NAFLD [4, 16]. However, these studies have cross-sectional designs; thus it was impossible to draw strong conclusions regarding the existence of causal relationships between WBC counts and NAFLD or the temporal sequence of events linking the two variables.…”

Section: Discussionmentioning

confidence: 99%

Associations between White Blood Cell Count and the Development of Incidental Nonalcoholic Fatty Liver Disease

Chung

Yim

Kim

et al. 2016

Gastroenterology Research and Practice

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Aims. Chronic low-grade inflammation is thought to be associated with the pathogenesis of nonalcoholic fatty liver disease (NAFLD). This study aimed to determine the association between serum white blood cell (WBC) counts and the development of incidental NAFLD. Methods. In this retrospective longitudinal cohort study, we recruited participants who underwent abdominal ultrasonography and blood samplings during medical checkups in both 2005 and 2010. A total of 2,216 subjects were included in our analyses. Results. The prevalence of NAFLD in 2010 increased steadily in conjunction with increasing WBC counts in 2005 after adjustment for body mass index (BMI) [odds ratio (OR) 2.44, 95% confidence interval (CI) = 1.49–4.00 for women and OR 2.42, 95% CI = 1.61–3.63 for men, lowest quartile versus highest quartile]. Multivariate regression analysis after adjusting for age, BMI, hypertension, smoking, triglycerides, HDL cholesterol, and glucose levels revealed that NAFLD was significantly associated with the highest WBC quartile compared to the lowest quartile [OR 1.85, 95% CI, 1.10−3.10 for women and OR 1.68, 95% CI, 1.08−2.61 for men]. Conclusions. We demonstrated that the risk of developing NAFLD was significantly associated with WBC counts independently of metabolic factors. This finding provides novel evidence indicating that serum WBC counts may be potential surrogate markers of NAFLD.

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Section: Discussionmentioning

confidence: 99%

Associations between White Blood Cell Count and the Development of Incidental Nonalcoholic Fatty Liver Disease

Chung

Yim

Kim

et al. 2016

Gastroenterology Research and Practice

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“…It encompasses a wide spectrum of histological features that range from simple steatosis to severe forms of fibrosis, steatohepatitis and even cirrhosis. [1][2][3] Its pathogenesis is not completely understood, but several abnormalities have been strongly linked to its onset, such as central obesity, insulin resistance, chronic inflammation, increased uptake of fatty acids by the liver and lipotoxicity. 4,5 NAFLD has been considered to be a hepatic manifestation of metabolic syndrome (MetS) and, as such, is strongly related to type 2 diabetes mellitus (T2DM).…”

Section: Introductionmentioning

confidence: 99%

Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals. A cross-sectional study

et al. 2016

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CONTEXT AND OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) has become a public health concern. It encompasses a wide spectrum of histological abnormalities and has close relationships with insulin resistance and type 2 diabetes mellitus (T2DM). This study sought to compare the histological alterations observed in morbidly obese individuals with and without T2DM who underwent Roux-en-Y gastric bypass. DESIGN AND SETTING: Cross-sectional study in a tertiary-level public hospital.METHODS: This was a cross-sectional study on 197 individuals who underwent gastric bypass surgery between 2011 and 2013. NAFLD was assessed through liver biopsies. T2DM was diagnosed through the International Diabetes Federation criteria. RESULTS: Non-diabetics presented significantly more biopsies without any histological abnormalities, regarding steatosis (42.6% versus 25.5%; P = 0.0400), fibrosis (60.6% versus 36.2%; P = 0.0042) and steatohepatitis (27.3% versus 12.8%; P = 0.0495), while diabetics presented significantly higher frequency of moderate forms of steatosis (36.2% versus 20%; P = 0.0307) and fibrosis (23.4% versus 4%; P = 0.0002). DISCUSSION: T2DM was associated with more advanced forms of NAFLD within the population studied. NAFLD has previously been correlated with severe forms of heart disease. CONCLUSION: Screening for and early detecting of NAFLD in high-risk populations are important for avoiding further development of severe forms and the need for liver transplantation. RESUMO CONTEXTO E OBJETIVO:A doença gordurosa não alcoólica do fígado se tornou um problema de saúde pública. Ela compreende um amplo espectro de alterações histológicas e se relaciona intimamente com a resistência insulínica e o diabetes mellitus tipo 2. Este estudo tem por objetivo comparar as alterações histológicas observadas em obesos mórbidos com e sem diabetes submetidos ao bypass gástrico em Y de Roux. TIPO DE ESTUDO E LOCAL: Estudo transversal em um hospital terciário público. MÉTODOS: Este é um estudo transversal que envolveu 197 indivíduos submetidos ao bypass gástrico entre 2011 e 2013. A doença gordurosa do fígado foi avaliada através de biópsia hepática. O diabetes mellitus tipo 2 foi diagnosticado através dos critérios da Federação Internacional de Diabetes. RESULTADOS: Indivíduos não diabéticos apresentaram significativamente mais biópsias sem anormalidades histológicas, em relação a esteatose (42,6% versus 25,5%; P = 0.04), fibrose (60,6% versus 36,2%; P = 0.0042) e esteato-hepatite (27,3% versus 12,8%; P = 0.0495); os diabéticos apresentaram uma frequên-cia significativamente mais alta de formas moderadas de esteatose (36,2% versus 20%; P = 0.0307) e fibrose (23,4% versus 4%; P = 0.0002). DISCUSSÃO: O DM-2 associou-se a formas mais avançadas de doença gordurosa do fígado dentro da população estudada. A doença gordurosa não alcoólica do fígado foi associada previamente com formas graves de doença cardíaca. CONCLUSÃO: A busca e detecção precoce da doença gordurosa em populações de alto risco são importantes para evitar o fut...

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“…Importantly, 1 mg/l increase in hs-CRP was shown to increase the risk of NAFLD by 1.7 times. Increased levels of other pro-inflammatory cytokines in AsianIndians with NAFLD have been shown in various studies 36,37 . …”

Section: Subclinical Inflammationmentioning

confidence: 89%

Non-Alcoholic Fatty Liver Disease in Asian Indians:Relationship With Insulin Resistance, Diabetes and Cardiovascular Risk

2017

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Prevalence of non-alcoholic fatty liver disease (NAFLD) varies in India; up to one-third of the urban population is affected by the disease. In Asian Indians, presence of NAFLD is driven by multiple factorspresence of excess abdominal fat (abdominal subcutaneous and intra-abdominal fat) and lifestyle factors (imbalanced diets and physical inactivity), and it is correlated closely with insulin resistance, the metabolic syndrome and dysglycaemia in the background of genetic predisposition (investigated genes in Asian Indians: APOC3, PNPLA-3, PPAR, SREBP-2, adiponectin, SAMM50, PARVB and PZP). Recent studies also show that presence of NAFLD independently correlates with subclinical inflammation and surrogate markers of atherosclerosis (carotid intima-media thickness, impaired flow-mediated vasodilatation) in Asian Indians. A prediction equation (Indian Fatty Liver Index) which includes simple measures has been developed for Asian Indians. On the other hand, increased (more than 15.6 cm) liver span (surrogate marker of fatty liver), in a preliminary study, predicted diabetes in non-obese Asian Indians. Dietary factors are important for the development of NAFLD, and some evidence indicates that regular use of high monounsaturated fatty acid rich oils, and low amount of saturated fat intake are beneficial.

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Inflammatory Markers in Relation to Nonalcoholic Fatty Liver Disease in Urban South Indians

Abstract: hsCRP and leukocyte count are associated with NAFLD after adjusting for conventional cardiometabolic risk factors.

Cited by 23 publications

References 31 publications

Associations between White Blood Cell Count and the Development of Incidental Nonalcoholic Fatty Liver Disease

Associations between White Blood Cell Count and the Development of Incidental Nonalcoholic Fatty Liver Disease

Influence of type 2 diabetes mellitus on liver histology among morbidly obese individuals. A cross-sectional study

Non-Alcoholic Fatty Liver Disease in Asian Indians:Relationship With Insulin Resistance, Diabetes and Cardiovascular Risk

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