Serum levels of acute phase proteins in patients with nonalcoholic steatohepatitis.
OBJECTIVE
A simple and practical method of detecting the degree of the inflammatory response during the development of nonalcoholic steatohepatitis has not been developed to date. In this study the serum levels of acute phase proteins in patients with nonalcoholic steatohepatitis and whether these levels had any relationship with histopathological findings in the liver were evaluated.


METHODS
The study included 18 patients with NASH diagnosed by liver biopsy (13 males and five females with a mean age of 44 years) and 16 healthy volunteers as a control group (11 males and five females, with a mean age of 40 years). The serum levels of C-reactive protein, C-reactive ceruloplasmin, ferritin, transferrin, alpha-1-acid glycoprotein, alpha-2-macroglobulin, alpha-1-antitripsin, albumin, haptoglobulin and lipoprotein (a) were determined by nephelometric method in both groups. In patients with nonalcoholic steatohepatitis, liver histopathology was assessed using a modified scoring system based on the classification defined by Brunt.


RESULTS
Serum C-reactive, ferritin, alpha-2-macroglobulin and ceruloplasmin concentrations in patients with nonalcoholic steatohepatitis were significantly higher than those of the control group (p=0.0001, p=0.001, p=0.007, p=0.01 respectively), but serum transferrin, albumin, haptoglobin, alpha-1-acid glycoprotein, alpha-1-antitripsin and lipoprotein (a) levels were not different. There was no difference in C-reactive protein levels regarding the degree of hepatic steatosis and inflammation and the stage of liver fibrosis. Acute phase proteins had no correlation with liver histology.


CONCLUSIONS
Measurement of serum C-reactive protein, ferritin, ceruloplasmin and alpha-2-macroglobulin levels may be useful in assessing patients at risk of nonalcoholic steatohepatitis and those with high C-reactive protein and ferritin but normal transferrin should be considered for liver biopsy.
Department of Gastroenterology, Gaziantep University School of Medicine, Gaziantep, Turkey. koruk@gantep.edu.tr
Mehmet
M
Koruk
Seyithan
S
Tayşi
M Cemil
MC
Savaş
Omer
O
Yilmaz
Fatih
F
Akçay
Metin
M
Karakök
D000209:Acute-Phase Proteins / Q000032:analysis*; D000328:Adult; D000368:Aged; D015415:Biomarkers; D001707:Biopsy, Needle; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D005234:Fatty Liver / Q000097:blood* / Q000473:pathology*; D005260:Female; D005293:Ferritins / Q000097:blood; D006242:Haptoglobins / Q000032:analysis; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D000511:alpha-Macroglobulins / Q000032:analysis
D000209:Acute-Phase Proteins; D015415:Biomarkers; D006242:Haptoglobins; D000511:alpha-Macroglobulins; D002097:C-Reactive Protein; D005293:Ferritins