Systemic inflammation in nonalcoholic fatty liver disease is characterized by elevated levels of CCL2

J Hepatol. 2006 Jun;44(6):1167-74. doi: 10.1016/j.jhep.2006.02.011. Epub 2006 Mar 20.


Background/aims: To elucidate the role of systemic inflammation in nonalcoholic fatty liver disease (NAFLD).

Methods: Serum samples in 47 patients with histologically verified NAFLD (22 with simple steatosis and 25 with nonalcoholic steatohepatitis [NASH]), and in 30 age-, sex- and ethnicity-matched healthy controls, were assessed for (i) general markers of inflammation (C-reactive protein [CRP], tumor necrosis factor [TNF]-alpha, and interleukin [IL]-6), (ii) chemokines (CC-chemokine ligand [CCL] 2/monocyte chemoattractant protein [MCP]-1, CCL19 and CCL21), (iii) adipocytokines related to insulin resistance and inflammation (adiponectin and leptin) and (iv) a marker of oxidative stress (8-isoprostane-F2alpha).

Results: Serum levels of several inflammatory cytokines were increased in NAFLD as compared to controls, and IL-6 (P=0.017), CCL2/MCP-1 (P=0.008) and CCL19 (P=0.001), but not CRP (P=0.199), remained elevated also after correction for sex, body mass index (BMI) and age. Comparing NASH with simple steatosis, levels of TNF-alpha (P=0.024) and CCL2/MCP-1 (P=0.012) were elevated and adiponectin (in women) (P=0.001) were decreased also after adjustment for sex, BMI and presence of the metabolic syndrome.

Conclusions: Our results indicate that patients with NAFLD are characterized by a low-grade systemic inflammation. The high CCL2/MCP-1 levels in NASH might be of importance for the conversion from simple steatosis to NASH.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Biomarkers / analysis
  • Biomarkers / blood
  • Chemokine CCL2 / analysis
  • Chemokine CCL2 / blood*
  • Chemokines / blood
  • Cytokines / blood
  • Fatty Liver / immunology*
  • Fatty Liver / pathology
  • Female
  • Hepatitis, Chronic / immunology*
  • Hepatitis, Chronic / pathology
  • Humans
  • Liver / chemistry
  • Liver / immunology
  • Male
  • Middle Aged
  • Oxidative Stress
  • Up-Regulation


  • Biomarkers
  • CCL2 protein, human
  • Chemokine CCL2
  • Chemokines
  • Cytokines