Targher G et al. (2005) Non-alcoholic hepatic steatosis and its relation to increased plasma biomarkers of inflammation and endothelial dysfunction in non-diabetic men. Role of visceral adipose tissue. Diabet Med 22: 1354–1358

Recent studies have shown an association between levels of proinflammatory biomarkers and the presence of visceral obesity. As the latter has been associated with fatty liver disease, Targher et al. investigated whether there is a relationship between nonalcoholic hepatic steatosis (HS) and chronic inflammation. Exclusion criteria included age >50 years, alcohol intake ≥20 g/day, drug use, smoking, and a clinical history of diabetes, or cardiovascular, kidney or liver illness.

A total of 100 male volunteers with (n = 35) and without (n = 65) HS participated in the study. Targher et al. compared the levels of plasma biomarkers of inflammation and endothelial dysfunction in both groups. They found that these were higher in men with HS (P ≤0.001). Statistical analyses showed that the level of visceral fat was the only factor that independently correlated with the presence of inflammation and endothelial dysfunction.

As this was a cross-sectional study, only a correlational link has been established; a causal relationship can only be inferred. In addition, nonalcoholic HS can only be definitively distinguished from steatohepatitis by liver biopsy, which was not performed. The possibility of a general relationship between nonalcoholic fatty liver disease and proinflammatory biomarkers cannot, therefore, be excluded.