Prognostic value of high sensitivity C-reaction protein in non-insulin dependent diabetes mellitus patients with non-alcoholic fatty liver disease.
OBJECTIVE
High sensitivity C-reaction protein (hsCRP) has been used as a significant predictive factor of cardiovascular events in patients with non-insulin dependent diabetes mellitus (NIDDM). However, existing reports in regards to the significance of hsCRP in predicting the progression of hepatic complications in NIDDM patients are too sparse to deliver clear results. This study is aimed at investigating the prognostic value of hsCRP in NIDDM patients with non-alcoholic fatty liver disease (NAFLD).


METHODS
1128 NIDDM patients with a definite diagnosis of NAFLD were enrolled and followed for one year. The baseline body mass index (BMI), waist-hip circumference ratio (WHR), serum aspartate aminotransferase (AST), presence of hypertension, alanine aminotransferase (ALT), serum hsCRP, total cholesterol (Tch), fasting blood glucose (FBG), triglycerine (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and hepatitis B surface antigen (HBsAg) were recorded to analyze the significance of hsCRP in predicting the short-term progression from NAFLD to non-alcoholic steatohepatitis (NASH).


RESULTS
One year after baseline, 32% of the NAFLD patients suffered progression to NASH and the percentages of NASH were respectively 8.2%, 12.5%, 33.8% and 72.6% in 4 groups with quartered baseline serum level of hsCRP; there was significant difference among the 4 groups in percentage of NASH (P<0.001). With sex, age, WHR, BMI, hypertension, TG, TCH, HDL-C, LDL-C, FBG and HBsAg included, the calibrated regression model gave the OR values of 1.000, 1.669, 6.635 and 32.131 in in 4 quartered baseline serum levels of hsCRP.


CONCLUSIONS
High serum level of hsCRP is an independent risk factor of short-term progression to NASH in patients with NIDDM and NAFLD. Those NIDDM patients with NAFLD that present with high serum level of hsCRP should be subjected to regular monitoring, lifestyle intervention and medication.
Department of Gastroenterology, 307 Hospital of PLA, Academy of Military Medical Science Beijing, China.
Yiliang
Y
Bi
Department of Gastroenterology, 307 Hospital of PLA, Academy of Military Medical Science Beijing, China.
Min
M
Min
Department of Gastroenterology, 307 Hospital of PLA, Academy of Military Medical Science Beijing, China.
Wei
W
Shen
Department of Gastroenterology, 307 Hospital of PLA, Academy of Military Medical Science Beijing, China.
Pei
P
Deng
Department of Gastroenterology, 307 Hospital of PLA, Academy of Military Medical Science Beijing, China.
Qiupeng
Q
Du
Department of Gastroenterology, 307 Hospital of PLA, Academy of Military Medical Science Beijing, China.
Mingjie
M
Dong
Department of Gastroenterology, 307 Hospital of PLA, Academy of Military Medical Science Beijing, China.
Yan
Y
Liu
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis*; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis; D008111:Liver Function Tests; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000175:diagnosis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation; D055815:Young Adult
D015415:Biomarkers; D002097:C-Reactive Protein
Non-insulin dependent diabetes mellitus; high sensitivity C-reaction protein; non-alcoholic fatty liver disease; non-alcoholic steatohepatitis