Evaluation of C-reactive protein levels in the differentiation of non-alcoholic steatohepatitis and simple liver steatosis

Abstract

Aim: Non-alcoholic fatty liver disease (NAFLD) is a broad-spectrum disease that has increased in recent years due to increased sedentary life and obesity. It was aimed to determine C-reactive protein (CRP) levels, its association with simple steatosis and non-alcoholic steatohepatitis (NASH) and its diagnostic value in this study. Methods: A total of 165 patients had a diagnosis of fatty liver disease (simple steatosis group and NASH group) and 99 healthy controls without liver disease were included in the study. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, direct bilirubin, CRP levels were evaluated and ultrasonographic evaluation of liver was performed in all groups. Histopathological evaluation was performed by biopsy in 65 patients who were thought to have NASH. Results: AST and ALT values were found to be significantly higher in the NASH group than the other groups. CRP levels were detected lowest in control group and highest in NASH group (p <0.001). AST values were also found to be significantly higher in patients with fibrosis grade 3-4 compared to the control group. Conclusion: Our study showed that CRP level is a suitable marker for differentiation of simple steatosis and NASH.

Keywords

• Non-alcoholic fatty liver disease
• C-reactive protein
• non-alcoholic steatohepatitis

Non-alkolik steatohepatit ve basit karaciğer yağlanması ayrımında C-reaktif protein düzeylerinin değerlendirilmesi

Öz

Amaç: Non-alkolik yağlı karaciğer hastalığı (NAFLD), artan sedanter hayat ve obezite nedeniyle son yıllarda artış gösteren geniş spektrumlu bir hastalıktır. Bu çalışmada, C-reaktif protein (CRP) düzeylerinin, basit steatoz ve non-alkolik steatohepatit (NASH) ile ilişkisini ve tanısal değerini belirlemek amaçlanmıştır. Metodlar: Yağlı karaciğer hastalığı tanısı alan 165 hasta (basit steatoz grubu ve NASH grubu) ve karaciğer hastalığı olmayan 99 sağlıklı kontrol çalışmaya dahil edildi. Tüm gruplarda aspartat aminotransferaz (AST), alanin aminotransferaz (ALT), total bilirubin, direkt bilirubin, CRP düzeyleri değerlendirildi ve karaciğerin ultrasonografik değerlendirmesi yapıldı. NASH olduğu düşünülen 65 hastada biyopsi ile histopatolojik değerlendirme yapıldı. Bulgular: AST ve ALT değerleri NASH grubunda diğer gruplara göre anlamlı olarak yüksekti. CRP düzeyleri kontrol grubunda en düşük, NASH grubunda en yüksek saptandı (p <0.001). Fibrozis derecesi 3-4 olan hastalarda kontrol grubu ile kıyaslandığında, AST değerinin anlamlı düzeyde yüksek olduğu saptandı. Sonuç: Çalışmamız, CRP düzeyinin basit steatoz ve NASH ayrımı için uygun bir belirteç olduğunu göstermiştir.

Anahtar Kelimeler

• Non-alkolik yağlı karaciğer hastalığı
• C-reaktif protein
• non-alkolik steatohepatit

Kaynakça

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