CORRELATION OF HIGH-SENSITIVITY C-REACTIVE PROTEIN (hs-CRP) AND TRIGLYCERIDE-GLUCOSE (TYG) INDEX RELATED PARAMETERS WITH DISEASE SEVERITY IN NON-ALCOHOLIC FATTY LIVER DISEASE (NAFLD) PATIENTS
Main Article Content
Keywords
NAFLD, steatosis, hs-CRP, Triglyceride-Glucose indices
Abstract
Background: Non-alcoholic fatty liver disease (NAFLD), a liver pandemic of the 21st century, impacts nearly 30% of the population worldwide. Since, chronic low-grade inflammation associated with the activation of innate immune system, plays an essential role in the pathogenesis of NAFLD, high sensitivity C-reactive protein (hs-CRP) levels, a known marker of chronic inflammation, can be of value for determining NAFLD severity. Also, since this sub-clinical inflammation has a causative role in generating insulin resistance, the prognostic value of triglyceride-glucose (TyG) index, an insulin resistance (IR) factor and its related indices: TyG combined with body mass index (TyG-BMI), waist circumference (TyG-WC) and TyG- waist circumference-to-height ratio (TyG–WHtR) were estimated Hence, in the present study, we aimed to elucidate the association of hs‑CRP and TyG (its related parameters) with NAFLD severity. Methods: The study was conducted on 168 ultrasonographically confirmed NAFLD patients (Age group: 35-55 years) categorized into 2 groups: Group 1: Mild steatosis) patients (n = 84) and Group 2: Moderate to Severe steatosis) patients (n=84). Serum hs-CRP levels were estimated by immunoturbidimetric assay on fully automated analyzer. Results: The serum hs-CRP levels were found to be significantly raised (p<0.05) in group 2 patients w.r.t group 1 subjects. TyG-BMI and TyG- WC shared a potential significant association (p<0.05) with the disease occurrence and severity. Conclusions: Thus, these findings highlighted that hs-CRP, TyG related indices (TyG-BMI and TyG-WC) might act as potent non-invasive serum biomarkers in monitoring and predicting the severity of NAFLD, hence in the screening or risk assessment, early and targeted therapeutic management of such patients.
References
2. Duseja A, Najmy S, Sachdev S, et al. High prevalence of non-alcoholic fatty liver disease among healthy male blood donors of urban India. JGH Open 2019;3(2):133-9.
3. Raeman R. Inflammation: The Straw That Broke the NAFLD Liver! Cell Mol Gastroenterol Hepatol 2022;13(4):1273-74.
4. Duseja A, Singh SP, De A, et al. Indian National Association for Study of the Liver (INASL) Guidance Paper on Nomenclature, Diagnosis and Treatment of Nonalcoholic Fatty Liver Disease (NAFLD). J Clin Exp Hepatol 2023;13(2):273-302.
5. Campos-Murguía A, Ruiz-Margáin A, González-Regueiro JA, et al. World J Gastroenterol 2020; 26(39):5919-43
6. Loscalzo, Fauci, Kasper, et al. HARRISON’S PRINCIPLES OF INTERNAL MEDICINE. New York: McGraw Hill Publishers 2022.
7. Kumar R, Porwal YC, Dev N, et al. Association of high-sensitivity C-reactive protein (hs-CRP) with non-alcoholic fatty liver disease (NAFLD) in Asian Indians: A cross-sectional study. J Family Med Prim Care 2020;9(1):390-94.
8. Nigam P, Bhatt SP, Misra A, et al. Non-alcoholic fatty liver disease is closely associated with sub-clinical inflammation: a case-control study on Asian Indians in North India. PLoS One 2013; 8(1):e49286.
9. Kogiso T, Moriyoshi Y, Shimizu S, et al. High-sensitivity C-reactive protein as a serum predictor of nonalcoholic fatty liver disease based on the Akaike Information Criterion scoring system in the general Japanese population. J Gastroenterol 2009;44(4):313-21.
10. Chen Q, Hu P, Hou X, et al. Association between triglyceride-glucose related indices and mortality among individuals with non-alcoholic fatty liver disease or metabolic dysfunction-associated steatotic liver disease. Cardiovasc Diabetol 2024;23(1):232.
11. Wang X, Liu J, Yu K, et al. Association between TyG-related parameters and NAFLD risk in Japanese non-obese population. Sci Rep 2025;15(1):7119.
12. Liu XY, Ma LN, Yan TT, Lu ZH, Tang YY, Luo X, et al. . Combined detection of liver stiffness and C-reactive protein in patients with hepatitis B virus-related liver cirrhosis, with and without hepatocellular carcinoma. Mol Clin Oncol 2016;4(4):587-90.
13. Kuppan G, Anjana RM, Deepa M, Paramasivam P, Chandrakumar S, Kaliyaperumal V, et al. Inflammatory markers in relation to nonalcoholic fatty liver disease in urban South Indians. Diabetes Technol Ther 2012;14(2):152-8.
14. Jamialahmadi T, Bo S, Abbasifard M, et al. Association of C-reactive protein with histological, elastographic, and sonographic indices of non-alcoholic fatty liver disease in individuals with severe obesity. J Health Popul Nutr 2023;42(1):30.
15. Lee J, Yoon K, Ryu S, et al. High-normal levels of hs-CRP predict the development of non-alcoholic fatty liver in healthy men. PLoS One 2017;12(2):e0172666.
16. Ma LN, Liu XY, Lu ZH, et al. Assessment of high-sensitivity C-reactive protein tests for the diagnosis of hepatocellular carcinoma in patients with hepatitis B-associated liver cirrhosis. Oncol Lett 2017;13(5):3457-64.
17. Zhu C, Huang D, Ma H, et al. High-Sensitive CRP Correlates With the Severity of Liver Steatosis and Fibrosis in Obese Patients With Metabolic Dysfunction Associated Fatty Liver Disease. Front Endocrinol (Lausanne) 2022;13:848937.
18. Zhou XD, Chen QF, Targher G, et al. High-Sensitivity C-Reactive Protein Is Associated With Heart Failure Hospitalization in Patients With Metabolic Dysfunction-Associated Fatty Liver Disease and Normal Left Ventricular Ejection Fraction Undergoing Coronary Angiography. J Am Heart Assoc 2024;13(3):e032997.
19. Virović-Jukić L, Stojsavljević-Shapeski S, Forgač J, et alNon-alcoholic fatty liver disease - a procoagulant condition? Croat Med J 2021;62(1):25-33.
20. Ogresta D, Mrzljak A, Cigrovski Berkovic M, et al. Coagulation and Endothelial Dysfunction Associated with NAFLD: Current Status and Therapeutic Implications. J Clin Transl Hepatol 2022;10(2):339-55.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Roli Saxena
Assistant Professor, Department of Biochemistry, Kalpana Chawla Government Medical College, Karnal.
Nikhil Govil
Associate Professor, Department of Medicine, Kalpana Chawla Government Medical College, Karnal.
Richa Goel
Assistant Professor, Department of Biochemistry, Kalpana Chawla Government Medical College, Karnal.
Himanshu Madaan
Professor and Head, Department of Biochemistry, Kalpana Chawla Government Medical College, Karnal.
Meenakshi Puri
Associate Professor, Department of Biochemistry, Kalpana Chawla Government Medical College, Karnal.