DIAGNOSTIC SIGNIFICANCE OF SERUM TISSUE NECROSIS FACTOR-ALPHA LEVEL IN NON- ALCOHOLIC FATTY LIVER DISEASE
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Keywords
Non-alcoholic fatty liver disease, Non-alcoholic steatohepatitis, Tissue Necrosis factor-alpha, receiver operating curve, and area under the curve.
Abstract
Background: Tissue necrosis factor (TNF-α) is a cytokine involved in systemic inflammation during acute-phase reactions. The current study was designed to investigate the levels of pro-inflammatory cytokine (TNF-α) during the progression of non-alcoholic fatty liver disease (NAFLD) from simple steatosis to non-alcoholic steatohepatitis (NASH) in patients and correlate the levels of cytokine with the progression of NAFLD.
Methods: The study included 60 diagnosed cases of NAFLD, including 31 patients with Fatty liver and 29 patients with NASH. Blood samples were collected at admission, and random blood glucose and serum liver function tests were measured. TNF-alpha levels were measured using a sandwich enzyme-linked immunosorbent assay (ELISA).
Results: Of the 60 NAFLD patients, TNF-α levels were elevated in both groups100% of Fatty Liver patients and 100% of NASH patients had elevated, higher in NASH patients (mean = 16.61 ± 2.70 pg/mL) than in those with fatty liver (mean = 11.15 ± 1.52 pg/mL), with the difference being statistically significant (P < 0.001). ROC curve analysis of TNF-α revealed good discriminatory role in differentiation between NASH and Fatty Liver, with an AUC of 0.961 and a P value <0.0001 optimum cut-off level obtained was <13.5pg/ml, with a sensitivity of 89.66% and a specificity of 100%.
Conclusion: Tnf-alpha levels can discriminate NASH from fatty liver in NAFLD, its role as a supporting biomarker for disease severity.
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Kumari Sharmila
Phd Scholar, Dept. of Biochemistry, SMS Medical College, Jaipur
Kumar Surendra
Senior Medical Officer, PHC Devta, Kotputli-Behror, Rajasthan
Singh Mamta
Associate Professor, Dept. Of Biochemistry, SMS Medical College, Jaipur
Jhajharia Ashok
Associate Professor, Dept. of Gastroenterology, SMS Medical College, Jaipur
Saini Shakuntala
Retd. Senior Professor, Dept. of Biochemistry, SMS Medical College, Jaipur