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Association of C-reactive protein with histological, elastographic, and sonographic indices of non-alcoholic fatty liver disease in individuals with severe obesity

Jamialahmadi, Tannaz; Bo, Simona; Abbasifard, Mitra; Sathyapalan, Thozhukat; Jangjoo, Ali; Moallem, Seyed Adel; Almahmeed, Wael; Ashari, Sorour; Johnston, Thomas P.; Sahebkar, Amirhossein


Tannaz Jamialahmadi

Simona Bo

Mitra Abbasifard

Ali Jangjoo

Seyed Adel Moallem

Wael Almahmeed

Sorour Ashari

Thomas P. Johnston

Amirhossein Sahebkar


BACKGROUND: Inflammation is critical in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). hs-CRP, an inflammatory marker, is considered one of the prognostic predictors of hepatic damage progression in NAFLD in some studies. METHODS: We assessed the concordance of hs-CRP concentrations and liver steatosis, steatohepatitis, and fibrosis based on elastography, sonography and liver biopsy findings in patients with severe obesity undergoing bariatric surgery. RESULTS: Among 90 patients, 56.7% showed steatohepatitis and 8.9% severe fibrosis. Hs-CRP were significantly associated with liver histology in an adjusted regression model (OR 1.155, 95% CI 1.029-1.297, p = 0.014; OR 1.155, 1.029-1.297, p = 0.014; OR 1.130, 1.017-1.257, p = 0.024 for steatosis, steatohepatitis, and fibrosis, respectively). The ROC curve, a cutoff of hs-CRP = 7 mg/L, showed a reasonable specificity (76%) for detecting biopsy-proven fibrosis and steatosis. CONCLUSION: hs-CRP was associated with any degree of histologically diagnosed liver damage, and it had a reasonable specificity for predicting biopsy-proven steatosis and fibrosis in obese individuals. Further studies are needed to identify non-invasive biomarkers that could predict NALFD progression due to the relevant health risks linked to liver fibrosis.


Jamialahmadi, T., Bo, S., Abbasifard, M., Sathyapalan, T., Jangjoo, A., Moallem, S. A., …Sahebkar, A. (2023). Association of C-reactive protein with histological, elastographic, and sonographic indices of non-alcoholic fatty liver disease in individuals with severe obesity. Journal of Health, Population and Nutrition, 42(1), Article 30.

Journal Article Type Review
Acceptance Date Mar 31, 2023
Online Publication Date Apr 7, 2023
Publication Date Apr 7, 2023
Deposit Date May 21, 2023
Publicly Available Date May 22, 2023
Journal Journal of health, population, and nutrition
Electronic ISSN 2072-1315
Publisher BioMed Central
Peer Reviewed Peer Reviewed
Volume 42
Issue 1
Article Number 30
Keywords Fatty liver; Steatohepatitis; Liver fibrosis; Fatty liver; Biopsy; Elastography; Inflammation
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© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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