Correlation Between IL-37 And Non-alcoholic Steatohepatitis

Background:The population of non-alcoholic fatty liver disease(NAFLD)has risen rapidly and affects human health.NAFLD is a series of hepatic injury diseases,with liver excessive lipid accumulation and steatosis,mainly including non-alcoholic fatty liver(NAFL),non-alcoholic steatohepatitis(NASH),cirrhosis,and hepatocellular carcinoma,except the causes of alcohol and other specific etiology.NASH plays an important role in the progression of NAFLD.The pathogenesis of NASH is closely related to inflammation,insulin resisitance,fat metabolism disorder and more.However the underlying mechanism for the development and progression of NASH is complex and multi-factorial.And the relevant research is still needed.Interleukin-37(IL-37)is an inhibitory cytokine.Studies have shown that IL-37 can inhibit the production and activity of inflammatory mediators and also plays an important role in our body.At present,research indicates that inflammatory suppression also has a great significance in NASH.IL-37 is involved in the development of various diseases,which may be related to the NASH.Objective:The purpose of’ this study is to examine and compare IL-37 in patients with non-alcoholic steatohepatitis(NASH)and healthy individuals.To analyze the correlation between IL-37 and tumor necrosis factor-a(TNF-a),biochemical indexes,insulin and insulin resistance.The correlation between IL-37 with TNF-α,biochemical indexes,and insulin resistance were analyzed.It aims to investigate the correlation between IL-37 and NASH.Methods:49 cases NASH patients in Northern Jiangsu People’s Hospital affiliated to YangZhou university were recruited from July 2017 to August 2018.32 cases of age and sex-matched healthy individuals were selected from the health physical examination center of the hospital and these subjects constituted the healthy control group.The clinical and laboratory indexes were recorded in detail,and the clinical data table was established.Meanwhile the concentration of serum levels of IL-37 and TNF-a were examined by enzyme linked immunosorbent assay.According to the statistical analysis,the levels of IL-37 and TNF-α were compared between the case group and control group.And then the correlation between IL-37 levels and the levels of inflammatory cytokine TNF-αK,transaminase,triglyceride,cholesterol,Low-density lipoprotein cholesterol,High-density lipoprotein cholesterol pasting insulin concentration and insulin resistance were analyzed.Results:1.The serum levels of IL-37 in patients with NASH was(198.90±27.77pg/ml)higher than the control groups which IL-37 was(178.03±21.15pg/ml),with statistical significance(P<0.01).Based on ROC curve,the best cut-off values of IL-37 for auxiliary diagnosis of NASH was 190.94pg/ml.The respective area of IL-37 under the receiver operating curve(AUC)was 0.727.The specificity was 75.0%,the sensitivity was 65.3%.2.The serum levels of IL-37 in NASH patients was positively correlated with TNF-α(r=0.295,P<0.05).3.The serum levels of IL-37 in NASH patients was positively correlated with HDL-C(r=0.306,P<0.05).4.The serum levels of IL-37 in NASH patients was negatively correlated with fasting insulin(r=-0.315,P<0.05).Conclusions:1.The serum levels of IL-37 in NASH patients was higher than those in healthy individuals,suggesting that IL-37 may be involved in the pathogenesis of NASH.2.The serum levels of IL-37 in NASH patients is positively correlated with TNF-α,suggesting that IL-37 may be involved in the regulation of NASH inflammatory responses.3.The serum levels of IL-37 in NASH patients is negatively related to HDL-C,suggesting that IL-37 may be involved in the regulation of lipid metabolism in NASH.4.The serum levels of IL-37 in NASH patients is negatively related to fasting insulin,suggesting that IL-37 may affect fasting insulin levels in NASH.