Circulating tumor necrosis factor‐α levels in non‐alcoholic fatty liver disease: A systematic review and a meta‐analysis. Issue 11 (30th July 2021)

• Record Type: Journal Article
• Authors: Potoupni, Victoria; Georgiadou, Maria; Chatzigriva, Eftychia; Polychronidou, Georgia; Markou, Erietta; Zapantis Gakis, Christos; Filimidou, Ioanna; Karagianni, Myriam; Anastasilakis, Dimitrios; Evripidou, Kleo; Ftergioti, Argyro; Togkaridou, Marianthi; Tsaftaridis, Nikolaos; Apostolopoulos, Apostolos; Polyzos, Stergios A
• Is Part Of: Journal of gastroenterology and hepatology. Volume 36:Issue 11(2021)
• Page Start: 3002
• Page End: 3014
• Publication Date: 2021-07-30
• Subjects: cytokines -- insulin resistance -- metabolic syndrome -- non‐alcoholic fatty liver disease -- tumor necrosis factor‐alpha; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.15631
• Languages: English
• ISSNs: 0815-9319

Abstract

Abstract: Background and Aim: To synthesize data on circulating tumor necrosis factor (TNF)‐α levels between patients with histologically confirmed non‐alcoholic fatty liver disease (NAFLD) (simple steatosis or non‐alcoholic fatty liver [NAFL] and/or non‐alcoholic steatohepatitis [NASH]) and controls. Methods: We performed a systematic search in PubMed, Scopus, and Cochrane Library. Fifty‐six studies, published between 2003 and 2019, were finally included, reporting data from 5848 individuals (1634 controls and 4214 NAFLD patients). Results: Higher circulating TNF‐α levels were observed in NAFLD patients than controls (standardized mean difference [SMD] 0.84; 95% confidence interval [95% CI] 0.59–1.09), NAFL patients than controls (SMD 0.56; 95% CI 0.27–0.85), NASH patients than controls (SMD 0.93; 95% CI 0.64–1.22), and NASH than NAFL patients (SMD 0.31; 95% CI 0.16–0.46). There were only minimal changes in the comparisons between groups after excluding studies with morbidly obese populations ( n = 11), or pediatric/adolescent populations ( n = 6), or other than enzyme‐linked immunosorbent assay method of TNF‐α measurement ( n = 8). There was high heterogeneity among studies in all comparisons, which was not essentially affected after sensitivity analyses. The meta‐regression analysis revealed that the male ratio was positively associated with TNF‐α SMD in the comparison between patients with NASH and NAFL (beta = 0.809; 95% CI 0.052–1.566) and accounted for 36% ( P = 0.037) of the heterogeneity in this pair of comparison. TNF‐α SMD was not associated with age, body mass index, and alanine aminotransferase in any pair of comparisons. Conclusions: Circulating TNF‐α levels were higher in patients with NAFLD compared with controls. Higher levels of circulating TNF‐α were also associated with the severity of NAFLD.