# Serum Inflammatory Markers and Dietary Inflammatory Index in Obese Individuals With Fatty Liver Disease: A Case–Control Study

**Authors:** Faezeh Tejareh, Laleh Payahoo, Seyed Ali Keshavarz

PMC · DOI: 10.1002/edm2.70181 · Endocrinology, Diabetes & Metabolism · 2026-03-03

## TL;DR

This study found that higher CRP levels are linked to fatty liver disease in obese individuals, but diet's inflammatory potential did not differ between groups.

## Contribution

The study provides new evidence on the role of systemic inflammation in fatty liver disease among obese individuals.

## Key findings

- Serum CRP levels were significantly higher in individuals with NAFLD compared to controls.
- CRP was positively associated with NAFLD, suggesting a role in its development.
- Dietary Inflammatory Index (DII) showed no significant association with NAFLD.

## Abstract

Fatty liver disease is common among obese individuals and is closely linked to chronic low‐grade inflammation. This study examines the relationship between dietary inflammatory index (DII) and serum inflammatory markers in obese individuals with and without non‐alcoholic fatty liver disease (NAFLD).

In this case–control study, 85 obese adults (BMI ≥ 30), aged 20–70 years, were recruited from two outpatient clinics in Urmia, Iran. NAFLD diagnosis was based on sonography by an endocrinologist. Serum C‐reactive protein (CRP) levels were measured using a high‐sensitivity immunoturbidimetric assay to assess systemic inflammation. Dietary intake was assessed using a validated semi‐quantitative food frequency questionnaire (FFQ). The Dietary Inflammatory Index (DII) was calculated to evaluate the inflammatory potential of the diet.

Serum CRP levels were significantly higher in the NAFLD group (12.2 mg/L; 95% CI: 9.7–14.7) than controls (8.5 mg/L; 95% CI: 6.0–11.0; p = 0.04). DII scores did not differ significantly between groups (p = 0.2). CRP was positively associated with NAFLD (OR = 2.89; 95% CI: 1.1–7.2), while DII showed no significant association (OR = 0.50; 95% CI: 0.2–1.2).

Our findings underscore the role of inflammation in the pathophysiology of fatty liver disease among obese individuals. Elevated CRP levels highlight potential targets for intervention. Although no significant differences in DII were observed, further serum investigation into the relationship between diet, inflammation and fatty liver is warranted.

Our findings underscore the role of inflammation in the pathophysiology of fatty liver disease among obese individuals. Elevated CRP levels highlight potential targets for intervention.

## Linked entities

- **Diseases:** non-alcoholic fatty liver disease (MONDO:0013209), fatty liver disease (MONDO:0004790)

## Full-text entities

- **Genes:** TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, IL10 (interleukin 10) [NCBI Gene 3586] {aka CSIF, GVHDS, IL-10, IL10A, TGIF}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, ADIPOQ (adiponectin, C1Q and collagen domain containing) [NCBI Gene 9370] {aka ACDC, ACRP30, ADIPQTL1, ADPN, APM-1, APM1}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, CRP (C-reactive protein) [NCBI Gene 1401] {aka PTX1}, IL4 (interleukin 4) [NCBI Gene 3565] {aka BCGF-1, BCGF1, BSF-1, BSF1, IL-4}
- **Diseases:** pain (MESH:D010146), hyperlipidemia (MESH:D006949), cirrhosis (MESH:D005355), liver disease (MESH:D008107), DII (MESH:D007249), diabetes (MESH:D003920), starvation (MESH:D013217), NAFLD (MESH:D065626), overweight (MESH:D050177), fatigue (MESH:D005221), autoimmune disorders (MESH:D001327), Obese (MESH:D009765), FL (MESH:D005234), metabolic disorders (MESH:D008659), insulin resistance (MESH:D007333), weight loss (MESH:D015431), infections (MESH:D007239), cardiovascular and hepatic complications (MESH:D002318), systemic (MESH:D015619), hepatitis (MESH:D056486)
- **Chemicals:** zinc (MESH:D015032), sugar (MESH:D000073893), salt (MESH:D012492), vitamin D (MESH:D014807), flavan-3-ols (MESH:C404987), flavonols (MESH:D044948), vitamin E (MESH:D014810), vitamin A (MESH:D014801), free fatty acids (MESH:D005230), iron (MESH:D007501), cholesterol (MESH:D002784), vitamin C (MESH:D001205), caffeine (MESH:D002110), antioxidant vitamins (-), olive oil (MESH:D000069463), selenium (MESH:D012643), carbohydrates (MESH:D002241), fatty acids (MESH:D005227), riboflavin (MESH:D012256), flavanones (MESH:D044950), thiamine (MESH:D013831), isoflavones (MESH:D007529), niacin (MESH:D009525), vitamin B12 (MESH:D014805), beta-carotene (MESH:D019207), polyphenol (MESH:D059808), folate (MESH:D005492), flavonoid (MESH:D005419), magnesium (MESH:D008274), alcohol (MESH:D000438), anthocyanidins (MESH:D000872), vitamin B6 (MESH:D025101), flavones (MESH:D047309)
- **Species:** Allium sativum (garlic, species) [taxon 4682], Homo sapiens (human, species) [taxon 9606], gut metagenome (species) [taxon 749906], Allium cepa (onion, species) [taxon 4679]

## Full text

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## Figures

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## References

27 references — full list in the complete paper: https://tomesphere.com/paper/PMC12957530/full.md

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Source: https://tomesphere.com/paper/PMC12957530