Comparison of TNF-α Levels in Alcoholic Liver Disease Patients with and without Hepatitis: A Cross-sectional Study in Coastal Karnataka, India

Introduction: Alcohol-induced liver injury triggers inflammatory reactions through pro-inflammatory cytokine Tumour Necrosis Factor-α (TNF-α). The estimation of TNF-α would provide valuable information on the degree of activation of immune system and inflammation in the liver cells, which is crucial...

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Main Authors: TM Anuraghi, Krishnamoorthy Srilatatha, Jinsha Fathima, Yassir Shaheena
Format: Article
Language:English
Published: JCDR Research and Publications Pvt. Ltd. 2025-04-01
Series:National Journal of Laboratory Medicine
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Online Access:https://www.njlm.net/articles/PDF/2915/76776_CE[Ra1]_F(SHU)_QC(SD_KR)_PF1(PS_IS)_redo_PFA(IS)_PB(PS_IS)_PN(IS).pdf
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author TM Anuraghi
Krishnamoorthy Srilatatha
Jinsha Fathima
Yassir Shaheena
author_facet TM Anuraghi
Krishnamoorthy Srilatatha
Jinsha Fathima
Yassir Shaheena
author_sort TM Anuraghi
collection DOAJ
description Introduction: Alcohol-induced liver injury triggers inflammatory reactions through pro-inflammatory cytokine Tumour Necrosis Factor-α (TNF-α). The estimation of TNF-α would provide valuable information on the degree of activation of immune system and inflammation in the liver cells, which is crucial in the diagnosis as well as prognosis of alcoholic hepatitis. Aim: To compare TNF-α levels in Alcoholic Liver Disease (ALD) patients with or without hepatitis. Materials and Methods: This cross-sectional study was conducted at Yenepoya Medical College Hospital, Mangaluru, Karnataka, India from October 2021 to June 2022. The study included 52 patients diagnosed with Alcoholic Liver Disease (ALD), aged between 45-75 years which were equally divided into two groups (n=26 each): ALD with hepatitis and ALD without hepatitis. The diagnosis of hepatitis was made based on the De Ritis ratio (>2) along with a history of alcohol consumption. The Liver Function Test (LFT) was estimated using the automated system. Child-Pugh (CP) score was assessed by scoring serum albumin, total bilirubin, Prothrombin Time (PT), ascites, and grades of hepatic encephalopathy. The TNF-α was estimated by the Enzyme Linked Immuno Absorbent Assay (ELISA). The LFT, CP score, and TNF-α levels were compared between ALD patients with or without hepatitis using Independent sample t-test. Results: All the study participants were male, with the median age of those with alcoholic hepatitis being 50.23 years. Around 65% of them had severe liver dysfunction with higher CP scores (p-value=0.001). Platelet count was significantly lower in alcoholic hepatitis, resulting in prolonged PT. Patients with alcoholic hepatitis had significantly high levels of bilirubin (p-value=0.006), aspartate transaminase (p-value=0.001), alkaline phosphatase (p-value=0.001), and TNF-α (p-value=0.005). Conclusion: The study concluded that the patients of ALD have elevation of TNF-α levels, when they progress to or have episodes of active hepatitis.
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spelling doaj-art-ea7dfa3148c94e47b1a174ab059a62952025-07-01T08:59:03ZengJCDR Research and Publications Pvt. Ltd.National Journal of Laboratory Medicine2277-85512455-68822025-04-01142BO12BO1510.7860/NJLM/2025/76776.2915Comparison of TNF-α Levels in Alcoholic Liver Disease Patients with and without Hepatitis: A Cross-sectional Study in Coastal Karnataka, IndiaTM Anuraghi0Krishnamoorthy Srilatatha1Jinsha Fathima2Yassir Shaheena3Postgraduate, Department of Biochemistry, Yenepoya Medical College, Yenepoya (Deemed to be University), Derelakatte, Mangaluru, Karnataka, India.Assistant Professor, Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.Tutor, Department of Anatomy, Yenepoya Medical College, Yenepoya (Deemed to be University), Derelakatte, Mangaluru, Karnataka, India.Associate Professor, Department of Biochemistry, Yenepoya Medical College, Yenepoya (Deemed to be University), Derelakatte, Mangaluru, Karnataka, India.Introduction: Alcohol-induced liver injury triggers inflammatory reactions through pro-inflammatory cytokine Tumour Necrosis Factor-α (TNF-α). The estimation of TNF-α would provide valuable information on the degree of activation of immune system and inflammation in the liver cells, which is crucial in the diagnosis as well as prognosis of alcoholic hepatitis. Aim: To compare TNF-α levels in Alcoholic Liver Disease (ALD) patients with or without hepatitis. Materials and Methods: This cross-sectional study was conducted at Yenepoya Medical College Hospital, Mangaluru, Karnataka, India from October 2021 to June 2022. The study included 52 patients diagnosed with Alcoholic Liver Disease (ALD), aged between 45-75 years which were equally divided into two groups (n=26 each): ALD with hepatitis and ALD without hepatitis. The diagnosis of hepatitis was made based on the De Ritis ratio (>2) along with a history of alcohol consumption. The Liver Function Test (LFT) was estimated using the automated system. Child-Pugh (CP) score was assessed by scoring serum albumin, total bilirubin, Prothrombin Time (PT), ascites, and grades of hepatic encephalopathy. The TNF-α was estimated by the Enzyme Linked Immuno Absorbent Assay (ELISA). The LFT, CP score, and TNF-α levels were compared between ALD patients with or without hepatitis using Independent sample t-test. Results: All the study participants were male, with the median age of those with alcoholic hepatitis being 50.23 years. Around 65% of them had severe liver dysfunction with higher CP scores (p-value=0.001). Platelet count was significantly lower in alcoholic hepatitis, resulting in prolonged PT. Patients with alcoholic hepatitis had significantly high levels of bilirubin (p-value=0.006), aspartate transaminase (p-value=0.001), alkaline phosphatase (p-value=0.001), and TNF-α (p-value=0.005). Conclusion: The study concluded that the patients of ALD have elevation of TNF-α levels, when they progress to or have episodes of active hepatitis.https://www.njlm.net/articles/PDF/2915/76776_CE[Ra1]_F(SHU)_QC(SD_KR)_PF1(PS_IS)_redo_PFA(IS)_PB(PS_IS)_PN(IS).pdfalcohol induced liver injurychild-pugh scorede ritis ratioinflammatory cytokinestumour necrosis factor-a
spellingShingle TM Anuraghi
Krishnamoorthy Srilatatha
Jinsha Fathima
Yassir Shaheena
Comparison of TNF-α Levels in Alcoholic Liver Disease Patients with and without Hepatitis: A Cross-sectional Study in Coastal Karnataka, India
National Journal of Laboratory Medicine
alcohol induced liver injury
child-pugh score
de ritis ratio
inflammatory cytokines
tumour necrosis factor-a
title Comparison of TNF-α Levels in Alcoholic Liver Disease Patients with and without Hepatitis: A Cross-sectional Study in Coastal Karnataka, India
title_full Comparison of TNF-α Levels in Alcoholic Liver Disease Patients with and without Hepatitis: A Cross-sectional Study in Coastal Karnataka, India
title_fullStr Comparison of TNF-α Levels in Alcoholic Liver Disease Patients with and without Hepatitis: A Cross-sectional Study in Coastal Karnataka, India
title_full_unstemmed Comparison of TNF-α Levels in Alcoholic Liver Disease Patients with and without Hepatitis: A Cross-sectional Study in Coastal Karnataka, India
title_short Comparison of TNF-α Levels in Alcoholic Liver Disease Patients with and without Hepatitis: A Cross-sectional Study in Coastal Karnataka, India
title_sort comparison of tnf α levels in alcoholic liver disease patients with and without hepatitis a cross sectional study in coastal karnataka india
topic alcohol induced liver injury
child-pugh score
de ritis ratio
inflammatory cytokines
tumour necrosis factor-a
url https://www.njlm.net/articles/PDF/2915/76776_CE[Ra1]_F(SHU)_QC(SD_KR)_PF1(PS_IS)_redo_PFA(IS)_PB(PS_IS)_PN(IS).pdf
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AT krishnamoorthysrilatatha comparisonoftnfalevelsinalcoholicliverdiseasepatientswithandwithouthepatitisacrosssectionalstudyincoastalkarnatakaindia
AT jinshafathima comparisonoftnfalevelsinalcoholicliverdiseasepatientswithandwithouthepatitisacrosssectionalstudyincoastalkarnatakaindia
AT yassirshaheena comparisonoftnfalevelsinalcoholicliverdiseasepatientswithandwithouthepatitisacrosssectionalstudyincoastalkarnatakaindia