Stellenwert der Akute-Phase-Proteine, CRP, Albumin, Fibrinogen, Ferritin, Transferrin und Coeruloplasmin in der Diagnostik der Steatosis hepatis - eine Untersuchung an 2445 Probanden einer zufälligen Bevölkerungsstichprobe
The metabolic syndrome and NAFLD gained more interest in clinical practice and in research. We investigated the prevalence of inflammation markers in subjects with sonographically detectable hepatic steatosis as part of a population-based cross-sectional study in Leutkirch, Southern Germany. Of the 2445 persons participating in this study, we excluded those with reported alcohol consumption of > 40g/d in males and > 20g/d in females, with chronic hepatitis B or C and those with known diabetes. The remaining group of 1807 subjects consisted of 969 women and 838 men. The overall prevalence of NAFLD was 23,9 % (n = 431), 16,3 % (n = 158) in females and 32,6 % (n = 273) in males. The persons with NAFLD showed significantly increased concentrations of ALT, AST, AP and GGT. ALT was the only liver enzyme with statistically significance in the multivariate analysis in the whole study population (p < ,0001) as well as in women (p = 0,0014) and in men (p < 0,0001). Speaking of the acute phase proteins, crp, fibrinogen, ferritin and coeruloplasmin were higher in subjects with NAFLD and had statistical significance (p = 0,008 and less). Ferritin and Coeruloplasmin were both strongly associated with the presence of NAFLD and were the only inflammation markers with multivariate significance. Elevated values of ferritin implied an odds ratio of 1,8 (1,2 - 2,5 p = 0,0018) for the general group or 2,1 (1,1 - 3,8 p = 0,017) in women and 1,7 (1,04 - 2,6 p = 0,034) in men. An increased concentration of coeruloplasmin meant an odds ratio of 4,3 (1,9 - 9,9 p = 0,0005) in the whole study group and 4,3 (1,6 - 11,3 p = 0,0035) in men. We found an independent association of ALT and the acute phase proteins ferritin and coeruloplasmin with the presence of non-alcoholic fatty liver disease. As the diagnosis and early treatment of NAFLD get more important these days, our findings can be helpful to detect persons at risk in a non-invasive way.
Subject HeadingsAkute-Phase-Proteine [GND]
C-reaktives Protein [GND]
Fatty liver [MeSH]