Abstract
Non-alcoholic fatty liver disease (NAFLD) affects about a quarter of the world's population and it is closely linked to hypertension (HT). Pro-inflammatory and anti-inflammatory cytokines play a key role in the pathology progression, and the search for non-invasive biomarkers for the diagnosis of NAFLD remains an important issue.
 The aim of the study was to determine the diagnostic and prognostic value of IL-1β and IL-10 in assessing the progression of liver parenchyma changes in patients with NAFLD and HT comorbidity.
 Materials and methods. A study of 115 patients with non-alcoholic steatohepatitis (NASH) was performed. The main group consisted of 63 patients with NASH and HT, 52 patients with isolated NAFLD represented the comparison group. Clinical and laboratory parameters were evaluated, IL-10 and IL-1β levels were measured by ELISA method, ultrasound steatometry and elastography were performed in all patients.
 Results. The attenuation coefficient and median liver stiffness in NAFLD and HT group significantly exceeded the results in the isolated NAFLD group and in the control group. The IL-1β level in NAFLD and HT group was 17.55 pg/ml, and in isolated NAFLD group the indicator averaged 15.72 pg/ml, which exceeded the control values (8.26 pg/ml). IL-10 level was 12.69 pg/ml and 14.34 pg/ml in patients with comorbid and isolated NAFLD, respectively, while control results averaged 16.19 pg/ml. It were found strong relationship between IL-1β, IL-10 and CRP levels in patients with NAFLD and HT (r=0.61, p=0.024, and r=-0.69, p=0.036, respectively). Inverse correlations were also found between the cytokines IL-1β and IL-10 in NAFLD patients with and without HT (r=-0.61, p<0.001, and r=-0.57, p<0.001, respectively). Changes in the cytokine status of patients with NAFLD at different stages of steatosis and liver fibrosis had been identified.
 Conclusions. The presence of concomitant HT in patients with NAFLD is associated with greater severity of liver parenchyma changes. NAFLD manifestation is accompanied by increase of IL-1β and decrease of IL-10 levels, and deepening of these deviations were found in patients with comorbidity of NAFLD and HT.
 Interleukins IL-1β and IL-10 can be defined as biomarkers of NAFLD progression both in its isolated course and in its comorbidity with HT. The possibility of using biomarkers as an independent non-invasive test of diagnosing NAFLD requires further study.
Highlights
Non-alcoholic fatty liver disease is the most common cause of chronic liver dysfunction
Anthropometric examination of patients showed that body mass index (BMI) in the groups with Non-alcoholic fatty liver disease (NAFLD)
The data indicate that the cytokine IL-10 levels decreases with deepening of steatosis chan ges according to NAS classification in the comorbidity of NAFLD and HT group
Summary
Non-alcoholic fatty liver disease is the most common cause of chronic liver dysfunction. The disease covers a wide range of histological pathologies from simple steatosis to non-alcoholic steatohepatitis (NASH), which affects 1.5–6.45 % of the population, liver fibrosis that develops in more than 40 % of patients with NASH, liver cirrhosis and hepatocellular carcinoma [3]. The results of studies indicate a bidirectional relationship between HT and fatty liver infiltration through common pathogenetic links, such as systemic inflammation, obesity, disorders of lipid and carbohydrate metabolism and oxidative stress. These data form the basis for considering the disease as equal and interdependent components of the metabolic syndrome [6, 7]
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