title: IL-6 and IGF-1 are independent prognostic factors of liver steatosis and non-alcoholic steatohepatitis in morbidly obese patients.
abstract: BACKGROUND
  Lipid accumulation and other histological liver markers characterize patients with non-alcoholic steatohepatitis (NASH). The identification of non-invasive prognostic factors of liver steatosis and NASH are relevant for the unravelling of the mechanisms of this disease, as well as for the clinical diagnoses of these patients.
  
  
  METHODS
  36 patients with morbid obesity and 12 healthy subjects were consecutively enrolled in this cross-sectional study to determine the serological parameters associated with the degree of hepatic steatosis and NASH. Clinical, biochemical and histologic variables were examined in blood and liver biopsies by descriptive, univariate and multivariate regression analysis.
  
  
  RESULTS
  The patients were distributed as non-NASH (14), probably-NASH (13) and NASH (9), according to the Non-alcoholic fatty liver disease Activity Score (NAS). The study identified remarkable differences in liver steatosis, and glucose, insulin, IL-6 and IGF-1 concentrations in blood among patients with morbid obesity. IL-6 was correlated with the degree of liver steatosis until the morbidly obese patients fulfil the criteria of NASH. The patients with NASH reduced IL-6 concentration in blood. IGF-1 decreased throughout the progression of NASH. TNF-alpha concentration was not related to liver steatosis or NASH in morbidly obese patients. The multivariate regression analysis identified glucose >110 mg/dL, IL-6 >4.81 pg/mL and IGF-1 <130 ng/mL, and homeostasis model assessment (HOMA) >4.5 and IGF-1 <110 ng/mL as independent predictors of hepatic steatosis and NASH, respectively.
  
  
  CONCLUSIONS
  The concentration of glucose, insulin, IL-6 and IGF-1 in blood are useful markers for the selection of patients with liver steatosis or NASH.
authors.affiliation: Liver Research Unit, Reina Sofia University Hospital, CIBER HEPAD, Cordoba, Spain.
authors.forename: David
authors.initials: D
authors.lastname: García-Galiano
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Sánchez-Garrido
authors.forename: Isabel
authors.initials: I
authors.lastname: Espejo
authors.forename: José Luis
authors.initials: JL
authors.lastname: Montero
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Costán
authors.forename: Trinidad
authors.initials: T
authors.lastname: Marchal
authors.forename: Antonio
authors.initials: A
authors.lastname: Membrives
authors.forename: José M
authors.initials: JM
authors.lastname: Gallardo-Valverde
authors.forename: Juan R
authors.initials: JR
authors.lastname: Muñoz-Castañeda
authors.forename: Eugenio
authors.initials: E
authors.lastname: Arévalo
authors.forename: Manuel
authors.initials: M
authors.lastname: De la Mata
authors.forename: Jordi
authors.initials: J
authors.lastname: Muntané
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006505:Hepatitis / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D015994:Incidence; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000150:complications / Q000473:pathology; D011237:Predictive Value of Tests; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D007334:Insulin-Like Growth Factor I