Evaluation of Some Biomarkers for the Diagnosis of Nonalcoholic Fatty Liver Disease in Egyptian Patients

Abstract

Background and Aims: Nonalcoholic fatty liver disease (NAFLD) is a silent disease; its spectrum includes simple steatosis, nonalcoholic steatohepatitis and fibrosis. Pro- and anti-inflammatory cytokines play roles in the pathogenesis of NAFLD and insulin resistance (IR). Moreover, plasma cell antigen-1(PC-1) and its gene polymorphism are related to IR and associated with NAFLD progression. Therefore, we aimed to detect the significance of biomarkers (IL-18, IL-10 and PC-1 levels), ultrasonographic & anthropometric findings and PC-1 K121Q genetic polymorphism in differentiating between NAFLD grades, since most previous investigators were concerned more with NAFLD patients without classifying them ultrasonographically into grades. Subjects and Methods: A total of 87 NAFLD patients (31 with grade 1 (mild NAFLD), 26 with grade 2 (moderate NAFLD) and 30 with grade 3 (severe NAFLD) were included in the study, in addition to 47 controls (grade 0). All subjects underwent ultrasonographic examination for NAFLD diagnosis. Serum interleukin-10 (IL-10), plasma interleukin-18 (IL-18) and plasma PC-1 levels were determined using enzyme-linked immunosorbent assay. Detection of PC-1 K121Q gene polymorphism by using restriction fragment length polymorphism (RFLP)-PCR. Determination of Homoeostasis model assessment (HOMA)-IR index. Results: Homoeostasis model assessment (HOMA)-IR index was higher in different NAFLD grades than in controls. Ultrasonographic and anthropometric findings and lipid profile indices (except for high-density lipoprotein cholesterol, which was decreased) were increased with NAFLD progression. Grade 3 patients showed significant increase in levels of IL-18 and significant decrease in IL-10 and PC-1 levels when compared to grade 1 patients. PC-1 gene polymorphism didn’t significantly change in parallel with NAFLD grades