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

Abstract

Objective: This study assessed the association of inflammatory markers, high-sensitivity C-reactive protein (hsCRP), and total leukocyte count with nonalcoholic fatty liver disease (NAFLD) in urban South Indians. Subjects and Methods: We randomly selected subjects with and without NAFLD (n = 100 each) from the Chennai Urban Rural Epidemiology Study conducted in Chennai in south India. NAFLD was diagnosed by ultrasonography. hsCRP was measured by nephelometry, and leukocyte count was measured by flow cytometry. Insulin resistance was analyzed by homeostasis assessment model using the following expression: fasting insulin (lIU/mL) · fasting glucose (mmol/L)/22.5. Results: Mean hsCRP values were significantly higher in subjects with NAFLD compared with those without (4.2 – 1.2mg/L vs. 2.2 – 0.4mg/L; P < 0.001). Leukocyte count was also higher in subjects with NAFLD compared with those without (7.8 – 1.4 · 103/lL vs 6.9 – 0.9 · 103/lL, P < 0.001). Both hsCRP (P < 0.001) and leukocyte count (P < 0.001) increased with increasing severity of NAFLD. Multiple logistic regression analysis was done using NAFLD as the dependent variable and hsCRP and leukocyte count as independent variables. Both hsCRP (odds ratio 1.293, 95% confidence interval 1.13–1.470, P < 0.001) and leukocyte count (odds ratio 1.293, 95% confidence interval 1.069–1.564, P = 0.008) had a significant association with NAFLD even after adjusting for waist circumference, insulin resistance, serum triglycerides, and presence of type 2 diabetes. Conclusions: hsCRP and leukocyte count are associated with NAFLD after adjusting for conventional cardiometabolic risk factors.