Serum Levels of TNF-alpha and Non-alcoholic Fatty Liver Disease in Type 2 Diabetes Mellitus Patients with Metabolic Syndrome

 

Methods: A total of 54 MetS patients with type 2 DM (26 males and 28 females) aged from 32 to 74 years and 20 healthy controls (8 males and 12 females) aged from 24 to 74 years were consecutively enrolled in this study. MetS and its individual components were defined according IDF 2009 criteria. Based on liver ultrasound, patients were classified into either having NAFLD or not. The serum concentrations of TNF-alpha were measured by commercially available enzyme-linked immunosorbent assay (R&D systems, USA).

 

Results: The prevalence of NAFLD in MetS patients with type 2 DM was 77,8 %. Mean plasma levels of TNF-alpha were significantly higher in all patients with MetS (5,05 +/- 2,6 pg/ml) and especially in those with NAFLD (5,22 +/- 2,6 pg/ml) compared to the controls (3,45 +/- 2,3 pg/ml; p<0,05). Patients with NAFLD were divided into groups with high and low levels of TNFalpha defined by the median value of TNF-alpha. Patients with high level of TNF-alpha showed significantly increased fasting glucose and liver transaminases concentrations in blood. The presence of NAFLD was associated with higher levels of TNF-alpha (OR = 4,26; 95% CI: 1,16 – 15,54; p = 0,028).

 

Conclusion: TNF-alpha participate in the pathogenesis of NAFLD and serum TNF-alpha concentrations could be a useful marker for early diagnosis of liver disturbances in patients with diabete mellitus type 2 and metabolic syndrome. Inhibition of TNF-alpha activity may be a potential approach to treat NAFLD patients.