Introduction Non-alcoholic steatohepatitis (NASH) is a growing global epidemic progressing to cirrhosis, liver failure, HCC, warrants liver transplant. The natural history is still not well defined, inflammatory cytokines, intrahepatic immune traffic, degree of apoptosis and path of fibrogenesis are the sequel of the disease process. This study evaluates a novel inflammatory cytokines (IL 10 and IL 12) ratio to predict NAFLD to NASH and its severity index.
Methods Ninety (n=90) patients, mean age of 45 (28–54) were divided into Group A (n=30) BMI (mean) <25% with normal lipids, healthy control. Group B NAFL D (n=30) BMI >29% with NAFLD (hepatic steatosis, Waist/Hip ratio >0.9, high lipids, HOMA >1.8, mean normal ALT, AST, RBP 4, 2.5, Leptin, Adiponectin, TNF α, serum NASH score <0.8, mean fibrotic score <0.1, mean IL 10/IL 12 ratio <0.9. NASH C (n=30), BMI >30, W/H ratio >1.1, high lipids, HOMA >2.2, high AST, ALT, RBP >4.5, high leptin, low adiponectin, high TNF α, IL10/IL12 ratio >2.5. Serums NASH score >0.6, fibrotic score over 0.2. Liver biopsy in NASH group, macrovascular fat 18/30 (60%), balloning 12/30 (40%), Mallory body 7/30 (23%), METAVIR score F2 12/30 (40%), F3 9/30 (30%), F4 3/30 (10%). Exclusion Criteria: Diabetes, viral hepatitis, autoimmune liver disease, alcohol consumption over 20 g daily, steatogenic medications including herbs.
Conclusion IL 10/12 ratio correlated positively with the progression of NAFLD to NASH. IL 10/12 ratio >2.5 has NASH with high steatosis and fibrotic state and elevated inflammatory cytokines. Larger study will establish the predictive index of IL10/IL 12 NASH severity and prognosis.
Competing interests None declared.
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