Association between the Severity of Nonalcoholic Fatty Liver Disease and High Sensitivity C-reactive Protein in Adults

Abstract

Background: The relationship between nonalcoholic fatty liver disease (NAFLD) and serum high sensitivity C reactive protein (hs-CRP) is not well established, and very few studies have addressed the role of serum hs-CRP as a predictor of NAFLD severity. Methods: We examined 3,905 subjects who visited a health promotion center and were over 19 years of age. A total of 948 subjects who satisfied the NAFLD criteria were included in the final analysis. Factors associated with serum hs-CRP level or affecting body fat distribution were excluded by testing total white blood cell count, serum creatinine level, and thyroid function. The subjects were categorized into 3 groups according to the amounts of hepatic fat contents. Hepatic steatosis was assessed by ultrasonography, and the diagnosis of metabolic syndrome was made on the basis of the National Cholesterol Education Program criteria. Metabolic risk factors and hs-CRP levels were analyzed. Results: According to the NAFLD severity, 832 subjects were categorized as normal, 92 subjects were included in the mild to moderate NAFLD group, and 24 subjects were categorized into the severe group. As the NAFLD progressed to severe, the frequencies of metabolic risk factors and elevated hs-CRP level were increased (P-trend < 0.01). In univariate analysis, most metabolic risk factors were associated with NAFLD severity in both gender but the significance for elevated blood pressure and abnormal hs-CRP level were noted inonly females. After adjusting for potential confounding variables, such as other metabolic risks and liver function test, the association with NAFLD severity and serum hs-CRP level remained significant in females and in obese