Expression And Significance Of Serum IL-32,IL-38,IL-6 And TNF-α In Patients With Non-Alcoholic Fatty Liver Disease

Objective: To study the expression of serum interleukin-32(IL-32),IL-38,IL-6 and tumor necrosis factor-α(TNF-α)in patients with non-alcoholic fatty liver disease(NAFLD)and the changes of IL-32,IL-38,IL-6 and TNF-α in patients with NAFLD before and after treatment,to analyze the relationship between IL-32,IL-38,IL-6,TNF-α and the severity of NAFLD,and to explore the role of IL-32,IL-38,IL-6 and TNF-α in the occurrence and development of NAFLD.Methods: According to the inclusion and exclusion criteria,patients with NAFLD aged 18-60 years were collected at Qingdao Central Hospital from July 2021 to May 2022 as case group.According to the controlled attenuation parameters(CAP)measured by the liver instantaneous elastic recorder,the patients were divided into mild group,moderate group and severe group.The healthy persons were collected as control group during the same period.The height and weight of the subjects were measured,BMI was calculated,and fasting venous blood was collected.Serum aminopherase of alanine acid(ALT),aminopherase of aspartic acid(AST),gamma-glutamyl transferase(γ-GT),total bile acid(TBA),triglyceride(TG),total cholesterol(TC),low density lipoprotein-cholesterol(LDLC),high density lipoprotein-cholesterol(HDL-C),free fat acids(FFAs)and uric acid(UA)were detected by automatic biochemical analyzer.The serum levels of IL-32,IL-38,IL-6and TNF-α were detected by ELISA.The patients in the case group were treated with Dangfei Liganning capsule and weight loss,and the above indexes were measured again after 3 months of treatment.Results: 1.A total of 38 cases in control group and 135 cases in case group were collected,including 22 cases in mild group,45 cases in moderate group and 68 cases in severe group.There was no significant difference in sex and age among the four groups(P > 0.05),and the data were comparable.BMI of severe group was significantly higher than that of control group,mild group and moderate group(P>0.05).BMI in the moderate group was significantly higher than that in the control group(P<0.05),and the rest were not significantly different(P>0.05).2.The serum levels of ALT,AST,γ-GT,UA,TG and HDL-C among the four groups were significantly higher than those in the control group(P<0.05).The levels of ALT,AST,γ-GT and UA in severe group were significantly higher than those in control group,mild group and moderate group(P<0.05),the levels of ALT,γ-GT and UA in the moderate group were significantly higher than those in the control group(P<0.05).The levels of serum UA in mild groups were significantly higher than control group(P<0.05).Serum TG in severe group was higher than that in control group and mild group(P<0.05),and serum TG in moderate group was higher than that in control group(P<0.05).Serum HDL-C in severe group was significantly lower than that in control group and moderate group(P<0.05),and the rest were not significantly different(P>0.05).3.The serum levels of IL-32,IL-38,IL-6 and TNF-α were significantly different among the four groups(P<0.001).Serum IL-32 levels in severe and moderate groups were significantly higher than those in control and mild groups(P< 0.05).The levels of IL-38 in severe group and moderate group were significantly higher than those in control group(P<0.05).The levels of IL-6 and TNF-α in severe group were significantly higher than those in control group,mild group and moderate group(P< 0.05),and the serum levels of IL-6and TNF-α in moderate group were significantly higher than those in control group(P<0.05).The rest were not significantly different(P>0.05).4.The serum levels of IL-32,IL-38,IL-6 and TNF-α were positively correlated with CAP,BMI,AST,ALT,γ-GT,TG and UA(P<0.05)and negatively correlated with HDL-C(P<0.05),there was no significant correlation with TBA,TC and LDL-C(P>0.05).Serum IL-38 was positively correlated with FFAs(P< 0.05),but serum IL-32,IL-6,TNF-α were not significantly correlated with FFAs(P>0.05).5.IL-32,IL-6 and TNF-α were positively correlated(P<0.05),IL-38 was positively correlated with IL-32,IL-6 and TNF-α(P< 0.05).6.After 3 months of treatment,the levels of CAP,BMI,ALT,AST,γ-GT,UA,IL-32,IL-38,IL-6 and TNF-α were significantly lower than those before treatment(P<0.05),the serum levels of TBA,TG,TC,LDL-C,HDL-C and FFAs were not significantly changed after treatment(P>0.05).7.After 3 months of treatment,the serum levels of IL-32,IL-38,IL-6 and TNF-α were significantly lower than those before treatment(P<0.05).Conclusion:1.The levels of inflammatory factors were correlated with serum liver enzymes,blood lipids,uric acid and the severity of NAFLD,it is suggested that the inflammatory factors IL-32,IL-38,IL-6,TNF-α are related to the liver injury,the abnormal metabolism of lipid and uric acid in NAFLD patients,and their expression level may be of clinical significance in judging the severity of NAFLD.2.There was a positive correlation between inflammatory factors,which suggested that IL-32,IL-38,IL-6 and TNF-α might interact with each other to co-regulate the inflammatory reaction in NAFLD.3.After 3 months of treatment,the CAP value and the levels of inflammatory cytokines were significantly decreased,suggesting that the serum levels of IL-32,IL-38,IL-6 and TNF-α may be used as evaluation indexes for the therapeutic effect of NAFLD.4.Combined detection of serum levels of IL-32,IL-38,IL-6 and TNF-α can better assess the severity of NAFLD and monitor disease progression in patients with NAFLD.