The Risk Factors And Change Of Tumor Necrosis Factor-α And Interleukin-6Levels In Primary Gout Patients Developing NAFLD

Objective:To explore the relation and risk factors of between gout and non-alcoholic fatty liver disease (NAFLD), and the role of tumor necrosis factor-α (TNF-a), interleukin-6(IL-6) between the two diseases.Method:1.77primary gout patients and47gout&type2diabetes mellitus patients were selected, who were admitted or diagnosed in Tianjin Medical University Metabolic Diseases Hospital during Oct.2012to Jul.2013;41healthy people were selected as the control group during the same time. A total of165subjects including116men and49women participated in this study.2. Records the following informations of the control, gout and gout&type2diabetes mellitus goups:(1) General informations:sex, age, height, weight, and body mass index was calculated (BMI=weight/height2,kg/m2);(2) Laboratory parameters:hemoglobin A1C (HbA1C), triglyceride (TG), total cholesterol (TC), high-density lipoprotein(HDL-C), low-density lipoprotein (LDL-C), alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (y-GGT), serum uric acid (SUA), blood urea nitrogen (BUN), serum creatinine(Scr), fasting plasma glucose (FPG), fasting insulin (FINS), the steady-state model method was used in calculating insulin resistance index (HOMA-IR)=FPG×FINS/22.5;(3) Measures human serum tumor necrosis factor-a, interleukin-6levels;(4) Acquisition liver B ultrasonic image, and use histograms to calculate the liver echo attenuation coefficient and liver/kidney ratio of the echo. Liver fat content=0.618X standardization of liver/kidney ratio of the echo+0.256X standardization of liver echo attenuation coefficient-0.530.3. Grouping:(1) Control group, gout group and gout&type2diabetes mellitus groups were divided into four groups again, according to the quartile of SUA levels, and the four groups were as follows from low to high respectively:group A, group B, group C, group D;(2) According to the quartile of liver fat content levels, the three groups were divided into four groups again, which were as follows from low to high respectively:group a, group b, group c, group d;(3) Divided these subjects into2groups according to whether they had NAFLD.Results:1. Compared with control group, gout and gout&type2diabetes mellitus groups showed a trend of increased detection rate of nonalcoholic fatty liver disease (29.3%,45.5%vs46.8%), and the liver fat content increased significantly;2. Compared with control group, the BMI, SUA, HbAlc, HOMA-IR, TG, ALT, ALP. Scr. liver fat content, TNF-α, IL-6were significantly higher in gout and gout&type2diabetes mellitus groups, HDL inverse (P<0.05):3. As serum uric acid rise. HOMA-IR, liver fat content, TNF-α, IL-6levels were increased;4. As liver fat content rise, TNF-α, IL-6levels were increased;5. The BMI, HOMA-IR. SUA, TG, CHO, LDL, ALT, AST, GGT. liver fat content, TNF-a, IL-6levels were significantly higher in subjects with NAFLD than who had no NAFLD (P<0.05);6. Liver fat content as the dependent variable and HOMA-IR, SUA, ALT, TNF-α, IL-6as the independent variable for the linear multivariate regression analysis, the results show TNF-α, IL-6for regression equation of liver fat content (β were0.060,0.220, respectively).Conclusion:1. Gout patients with or without T2DM showed a trend of increased prevalence of NAFLD. The liver fat content increased significantly and increased with serum uric acid levels elevating.2. Obesity, insulin resistance and lipid metabolism disorder were main risk factors for gout patients developing NAFLD.3. TNF-a and IL-6may play an important role in gout patients with NAFLD.