Complement C3 as a potential NAFLD predictor in an Egyptian cohort with diabetes and/or obesity

Abstract

Complement system is becoming increasingly recognized as being intimately tied to obesity and other various metabolic abnormalities linked to it and may be involved in NAFLD. The goal of this study was to see if complement C3 might be used as a diagnostic and prognostic marker in NAFLD patients. Forty-one NAFLD patients and fourteen age- and gender-matched control individuals were enrolled in this study. All subjects were subjected to abdominal ultrasound examination and clinical assessment with special emphasis on the liver function enzymes, blood glucose levels, lipid profile, and kidney function tests. Non-invasive assessment of hepatic steatosis and fibrosis has evolved using serology-based scoring systems such as the Fibrosis-4 score and NAFLD Fibrosis Score (NFS). Additionally, serum levels of complement C3 were determined by the ELISA method. In this study, BMI, cholesterol, triglyceride levels, and NFS were all substantially higher in NAFLD patients compared to healthy controls. Moreover, complement C3 was considerably higher in NAFLD cases (1.52±0.29 g/L) vs. healthy controls (0.93±0.289 g/L) (p<0.001). Compared to lean people (0.93±0.29 g/L), the mean complement C3 levels were significantly higher in obese diabetes (1.69±0.29 g/L), obese non-diabetic (1.48±0.174 g/L), and diabetic non-obese patients (1.36±0.28 g/L). Using a cutoff for complement C3 1.135 (g/L) for distinguishing NAFLD patients from healthy controls has a sensitivity of 90.2% and specificity of 78.6%. In conclusion, serum complement C3 may be useful in the identification of fibrosis in non-alcoholic fatty liver disease. Moreover, complement C3 may be a promising tool for predicting the worsening of liver inflammation.