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High-sensitivity C-reactive protein is an independent clinical feature of nonalcoholic steatohepatitis (NASH) and also of the severity of fibrosis in NASH

  • Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

The changes in nonalcoholic fatty liver disease (NAFLD) range over a wide spectrum, extending from steatosis to steatohepatitis (NASH). However, it has remained difficult to differentiate between NASH and nonprogressive NAFLD by clinical examination. We investigated the interrelationships between serum high-sensitivity C-reactive protein (hs-CRP) and the pathogenesis and progression of NASH.

Methods

Hs-CRP was measured in 100 patients with histologically verified NAFLD (29 with steatosis and 71 with NASH), and a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) analysis was performed to measure the intrahepatic mRNA expressions of CRP and interleukin (IL)-6.

Results

The results of a multiple regression analysis revealed that in comparison with cases of steatosis, hs-CRP was significantly elevated (P = 0.0048) in cases of NASH. Furthermore, among patients with NASH, hs-CRP was significantly elevated in those with advanced fibrosis compared with that in those with mild fibrosis (P = 0.0384), even after adjustment for age, sex, presence of diabetes, body mass index, visceral fat area, subcutaneous fat area, homeostasis model assessment for insulin resistance, high-density lipoprotein cholesterol, triglyceride, and low-density lipoprotein cholesterol. The results of the RT-PCR analysis showed that intrahepatic mRNA expression of CRP, but not IL-6, was increased in patients with NASH compared with those with steatosis (P = 0.0228).

Conclusions

This is the first report to demonstrate consistent and profound elevation of hs-CRP in cases of NASH compared with in cases of simple nonprogressive steatosis. Our results suggest that hs-CRP may be a clinical feature that not only distinguishes NASH from simple nonprogressive steatosis but also indicates the severity of hepatic fibrosis in cases of NASH.

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Authors and Affiliations

  1. Division of Gastroenterology, Yokohama City University Hospital, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Masato Yoneda, Hironori Mawatari, Koji Fujita, Hiroshi Iida, Kyoko Yonemitsu, Shingo Kato, Hirokazu Takahashi, Hiroyuki Kirikoshi, Masahiko Inamori, Yuichi Nozaki, Yasunobu Abe, Kensuke Kubota, Satoru Saito & Atsushi Nakajima

  2. Division of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Tomoyuki Iwasaki & Yasuo Terauchi

  3. Division of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Shinji Togo

  4. Kitakashiwa Rehabilitation Hospital, Kashiwa, Japan

    Shiro Maeyama

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  1. Masato Yoneda
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Yoneda, M., Mawatari, H., Fujita, K. et al. High-sensitivity C-reactive protein is an independent clinical feature of nonalcoholic steatohepatitis (NASH) and also of the severity of fibrosis in NASH. J Gastroenterol 42, 573–582 (2007). https://doi.org/10.1007/s00535-007-2060-x

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