title: Risk factors associated with non-alcoholic fatty liver disease in Chinese patients and the role of tumor necrosis factor-alpha.
abstract: OBJECTIVE
  Tumor necrosis factor-alpha (TNFalpha) has been reported to be associated with insulin resistance and induce inflammatory cytokines formation. Previous studies in human and animals showed inhibition of TNF-alpha improved severity of non-alcoholic fatty liver disease (NAFLD). The aims of this study were to measure plasma levels of TNFalpha in NAFLD and healthy subjects and investigate potential risk factors.
  
  
  METHODS
  A total of 144 patients (90 NAFLD, 50 controls) were enrolled. Clinical and laboratory data of each patient were collected. Plasma levels of TNF-alpha were measured with a commercially available solid phase sandwich enzyme-linked immunosorbent assay (R&D systems, USA). The lower detection limit of this assay was 0.12 pg/mL.
  
  
  RESULTS
  Multivariate analyses showed elevated triglyceride (odds ratio: 7.30, p<0.001) and BMI >25 kg/m2 (odds ratio: 3.57, p<0.005) were the two factors associated with NAFLD. Mean plasma level of TNF-alpha was significantly higher in NAFLD patients with abnormal ALT than controls (2.63+/-0.44 pg/mL vs. 1.56+/-0.10 pg/mL, p=0.016). Modest correlations were noted between plasma levels of TNF-alpha with ALT (r=0.25, p<0.005) and triglyceride (r=0.40, p<0.001).
  
  
  CONCLUSIONS
  TNF-alpha may participate in the pathogenesis of NAFLD. Inhibition of TNF-alpha activity by drugs or antibodies may be a potential approach to treat NAFLD patients.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan 11217, Republic of China. cjchu@vghtpe.gov.tw
authors.forename: Chi-Jen
authors.initials: CJ
authors.lastname: Chu
authors.forename: Rei-Hwa
authors.initials: RH
authors.lastname: Lu
authors.forename: Sun-Sang
authors.initials: SS
authors.lastname: Wang
authors.forename: Full-Young
authors.initials: FY
authors.lastname: Chang
authors.forename: Shwu-Ling
authors.initials: SL
authors.lastname: Wu
authors.forename: Chia-Ling
authors.initials: CL
authors.lastname: Lu
authors.forename: Bie-Chin
authors.initials: BC
authors.lastname: Chun
authors.forename: Chiao-Yu
authors.initials: CY
authors.lastname: Chang
authors.forename: Min-Yu
authors.initials: MY
authors.lastname: Wu
authors.forename: Shou-Dong
authors.initials: SD
authors.lastname: Lee
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D005234:Fatty Liver / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000502:physiology*
chemical_list: D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; D000410:Alanine Transaminase