Serum hs-CRP levels do not indicate the severity of liver damage in non-alcoholic steatohepatitis patients with type-2 diabetes mellitus

Kocabay G., Telci A., Tutuncu Y., Tiryaki B., Özel S., Çevikbaş U., ...Daha Fazla

Nobel Medicus, cilt.6, sa.2, ss.43-46, 2010 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 6 Sayı: 2
  • Basım Tarihi: 2010
  • Dergi Adı: Nobel Medicus
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.43-46
  • Anahtar Kelimeler: Brunt's classification system, hs-CRP, Liver enzymes, Non-alcoholic steatohepatitis (NASH), Type 2 diabetes mellitus
  • Bilecik Şeyh Edebali Üniversitesi Adresli: Hayır

Özet

• Objective: Non-alcoholic steatohepatitis (NASH) is a commonly encountered community health problem which is associated with obesity, insulin resistance and type 2 diabetes. There is no clinical or biochemical indicator predicting the prognosis of NASH. Therefore, it is not possible to predict the course of NASH in which patients may stay as a benign condition or in which it may progress to fibrosis or rarely cirrhosis. High sensitive C-reactive protein (hs-CRP) is a commonly used acute phase reactant which increases in even mild inflammatory states. In this study, we investigated the relationship between hs-CRP and inflammation in liver tissue in cases with NASH and type 2 diabetes mellitus. • Material and Method: The study included 52 NASH cases with type 2 diabetes mellitus. NASH was diagnosed based on biochemical tests and ultrasound images of the liver. Each patient had a true cut liver biopsy. Histopathological evaluation of biopsy specimens were performed following Hematoxilen-Eosin and Mason Trichrome stains according to the Brunt Criteria. Fasting blood glucose (FBG), alkaline phosphatase (ALP), aspartat and alanine aminotransferase (AST and ALT), lactic dehydrogenase, gamma glutamyl transpeptidase (GGT), Hemoglobin (A1c) and hs-CRP levels were investigated. Insulin resistance was calculated using "Homeostasis Model of Assessment" (HOMA-IR) formula. • Results: Serum levels of hs-CRP were tended to be higher as the severity of steatosis increased, however, did not reach to a statistical difference (3.6±3.4 mg/l in mild, 4.1±2.4 mg/l in moderate, and 6.0±4.4 mg/l in severe groups (Kruskal-Wallis variance analysis p= 0.18). Comparison of hs-CRP levels with and without inflammation or with and without fibrosis revealed similar tendency (respectively, p= 0.20 and p= 0.29). Hs-CRP was positively correlated with A1c, FBG, ALP, GGT and negatively correlated with AST. After adjustment of age and duration of diabetes, the above mentioned correlations remained same. • Conclusion: Positive correlations between hs-CRP levels and cholestatic liver enzymes (ALP, GGT) suggested that peripheral inflammatory markers reflect the functional disorder. However, hs-CRP level did not seem to play a predictive role in progressive steatosis, inflammation or fibrosis.