Endocrine Abstracts

Tumour necrosis factor-α (TNF-α) impairs liver function and contributes to the pathogenesis of nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (DM-2) with different trophological status.

Purpose: To assess the relationship between the level of TNF-α and indices of carbohydrate metabolism in patients with NAFLD and its combination with DM-2 with different trophological status.

Methods: 90 patients with isolated NAFLD and in combination with DM-2 with normal weight and obesity (BMI ≥30 kg/m²) were divided into three groups: 1 group (n=20) – comprized the patients with NAFLD, 2 group (n=20) – patients with combination of NAFLD and DM-2 with normal body weight and 3 group (n=50) – patients with comorbid disorder and obesity. The controls (n=20) were apparently healthy individuals. The levels of insulin (IRI) and TNF-α were determined by ELISA method.

Results: TNF-α was significantly (P<0.001) increased in all groups as compare to the control (24.2±1.06 pkg/ml), the level was the highest in group 3 (96.6±0.72 pkg/ml) and was significantly different from that in groups 1 and 2 (66.2±1.07 pkg/ml and 86.4±1.21 pkg/ml, respectively). In groups 1 and 2 the correlation was established between TNF-α and IRI (r=0.33, P<0.05 and r=0.37; P<0.05, respectively). In group 3 the significant correlation was established between the level of TNF-α and fasting blood glucose (r=0.46; P<0.05), IRI (r=0.78; P<0.05) and HOMA-IR (r=0.64; P<0.05).

Conclusion: The correlation between TNF-α and indices of carbohydrate metabolism is connected with the ability of TNF-α to enhance the carbohydrate metabolism, insulin resistance, and support the role of TNF-α in pathogenesis of NAFLD, namely, in damage of hepatic gluconeogenesis, especially in patients with associated DM-2 and obesity. In addition, isolated NAFLD can independently cause the metabolic consequences.