title: Non-alcoholic fatty liver disease is closely associated with sub-clinical inflammation: a case-control study on Asian Indians in North India.
abstract: OBJECTIVE
  Association between sub-clinical inflammation and non-alcoholic fatty liver disease (NAFLD) has not been studied in Asian Indians. In this case-control study, we aimed to analyse association of NAFLD with the sub-clinical inflammation and metabolic profile in Asian Indians in north India.
  
  
  METHODS
  Ultrasound diagnosed 120 cases of NAFLD were compared to 152 healthy controls without NAFLD. Anthropometric profile [body mass index (BMI), waist circumference (WC), hip circumference (HC)], high-sensitivity C-reactive protein (hs-CRP), metabolic profile [fasting blood glucose (FBG), lipid profile] and hepatic function tests [alanine aminotransferase (ALT) and aspartate aminotransferase (AST)] were recorded.
  
  
  RESULTS
  Metabolic parameters [FBG, total cholesterol (TC), serum triglycerides (TG),low-density lipoprotein (LDL-c)], hs-CRP and prevalence of the metabolic syndrome were higher in cases as compared to controls (p-value<0.05 for all). The median (range) of hs-CRP (mg/L) for cases [2.6(0.2-13.4)] were significantly higher than in controls [1.4(0.03-11.4), p = 0.01]. Similarly, higher values of hs-CRP were obtained when subgroups of cases with obesity, abdominal obesity and the metabolic syndrome were compared to controls [2.75 (0.03-14.3) vs. 1.52 (0.04-14.3), p = 0.0010; 2.8 (0.03-14.3) vs. 1.5 (0.06-14.3), p = 0.0014 and 2.7 (0.5-14.3) vs. 1.6 (0.06-8.5), p = 0.0013, respectively. On multivariate logistic regression analysis BMI (p = 0.001), WC (p = 0.001), FBG (p = 0.002), TC (p = 0.008), TG (p = 0.002), blood pressure (p = 0.005), metabolic syndrome (p = 0.001) and hs-CRP (p = 0.003) were significantly and independently associated with NAFLD. After adjusting for significant variables, the association between high hs-CRP and NAFLD remained large and statistically significant [adjusted OR = 1.17, 95% confidence interval (CI) = 1.05-1.29]. An increase in 1 mg/dl of hs-CRP level calculated to increase the risk of developing NAFLD by 1.7 times as compared to controls after adjusting for significant variables associated with NAFLD.
  
  
  CONCLUSIONS
  In this cohort of Asian Indians in North India, presence of NAFLD showed independent relationships with sub-clinical inflammation.
authors: National Diabetes Obesity and Cholesterol Foundation (N-DOC), SDA, New Delhi, India.
authors: Priyanka
authors: P
authors: Nigam
authors: Surya P
authors: SP
authors: Bhatt
authors: Anoop
authors: A
authors: Misra
authors: Meera
authors: M
authors: Vaidya
authors: Jharna
authors: J
authors: Dasgupta
authors: Davinder Singh
authors: DS
authors: Chadha
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D044466:Asian People / Q000208:ethnology; D001219:Aspartate Aminotransferases / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005234:Fatty Liver / Q000145:classification / Q000150:complications* / Q000208:ethnology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007249:Inflammation / Q000097:blood / Q000150:complications* / Q000208:ethnology; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography
chemical_list: D001786:Blood Glucose; D008078:Cholesterol, LDL; D014280:Triglycerides; D002097:C-Reactive Protein; D002784:Cholesterol; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase