Pro- and anti-inflammatory cytokines in steatosis and steatohepatitis.
BACKGROUND
Fatty liver disease is a problem in both bariatric patients and in patients with moderate obesity. Tumor necrosis factor (TNF)-alpha has been frequently measured in nonalcoholic steatohepatitis (NASH) with or without diabetes, but less is known about interleukin (IL)-6 and IL-10.


METHODS
Moderately obese patients (n = 80) with histologically proven steatosis (n = 29) and NASH (n = 51) were recruited. Serum levels of cytokines were documented along with clinical information. The aim was to identify the correlates of such biomolecules in a stable population.


RESULTS
Diabetes tended to be more associated with NASH (52.5% instead of 41.4%, P = 0.015), with no difference of age, gender, or body mass index regarding steatosis. For the entire population, cytokine changes were not significant, including TNF-alpha and IL-6. In diabetics only, all markers tended to diminish with NASH, especially IL-10 (P = 0.000). IL-10 correlated with homeostatic model assessment index (P = 0.000) and other variables of glucose homeostasis in diabetes, thus representing a major marker of the disease.


CONCLUSIONS
(1) Generally inconsistent changes in pro- and anti-inflammatory cytokines occurred when NASH was globally compared to steatosis. (2) In contrast, downregulation of IL-6 and IL-10 was perceived in diabetics with NASH. (3) Arterial hypertension did not play a role in these circumstances. (4) IL-10 maintained strong correlations with glucose metabolism indices. (5) TNF-alpha could not be incriminated for progressive liver damage, as values failed to increase in NASH. (6) Investigations of IL-10 and other counterregulatory cytokines are lacking in this context and deserve further studies.
Rabelo
Fabiola
F
Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil.
Oliveira
Claudia P M S
CP
Faintuch
Joel
J
Mazo
Daniel F C
DF
Lima
Vicencia M R
VM
Stefano
Jose Tadeu
JT
Barbeiro
Hermes V
HV
Soriano
Francisco G
FG
Alves
Venancio A Ferreira
VA
Carrilho
Flair J
FJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005234:Fatty Liver / Q000097:blood* / Q000150:complications; D005260:Female; D006505:Hepatitis / Q000097:blood* / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D007249:Inflammation; D016753:Interleukin-10 / Q000378:metabolism*; D015850:Interleukin-6 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications; D011446:Prospective Studies; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D055815:Young Adult
D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10
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