title: 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.
  
  
  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 (μIU/mL)×fasting glucose (mmol/L)/22.5.
  
  
  RESULTS
  Mean hsCRP values were significantly higher in subjects with NAFLD compared with those without (4.2±1.2 mg/L vs. 2.2±0.4 mg/L; P<0.001). Leukocyte count was also higher in subjects with NAFLD compared with those without (7.8±1.4×10(3)/μL vs 6.9±0.9×10(3)/μL, 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.
authors.affiliation: Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases Prevention and Control, IDF Centre for Education, Gopalapuram, Chennai, India.
authors.forename: Gokulakrishnan
authors.initials: G
authors.lastname: Kuppan
authors.forename: Ranjit Mohan
authors.initials: RM
authors.lastname: Anjana
authors.forename: Mohan
authors.initials: M
authors.lastname: Deepa
authors.forename: Prabu
authors.initials: P
authors.lastname: Paramasivam
authors.forename: Sathishkumar
authors.initials: S
authors.lastname: Chandrakumar
authors.forename: Velmurugan
authors.initials: V
authors.lastname: Kaliyaperumal
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Mohan
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D005215:Fasting / Q000097:blood; D005234:Fatty Liver / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods; D006801:Humans; D007194:India / Q000453:epidemiology; D007249:Inflammation / Q000097:blood*; D007333:Insulin Resistance; D007958:Leukocyte Count / Q000379:methods; D008297:Male; D065626:Non-alcoholic Fatty Liver Disease; D012307:Risk Factors; D014463:Ultrasonography; D014505:Urban Population
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein