Association Between Tumor Necrosis Factor-α and the Risk of Hepatic Events: A Median 3 Years Follow-Up Study

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Background: Tumor necrosis factor-α (TNF-α) is thought to be involved in the development of non-alcoholic fatty liver disease (NAFLD). However, it is still undetermined whether TNF-α is a significant indicator of major adverse hepatic events (MAHE). Methods: A total of 279 participants with TNF-α data were enrolled and assigned into three different groups based on the serum TNF-α level. The severity of NAFLD was evaluated with magnetic resonance imaging to determine liver proton density fat fraction. The association between TNF-α and MAHE as well as the association between TNF-α and all-cause death were evaluated with the risk-djusted Cox Proportional-hazards Model. Results: Compared with those in the lowest tertile, participants with highest TNF-α level displayed higher serious hepatic events or burden. After a median 3 years follow-up period, participants with highest TNF-α had a higher risk of MAHE (HR 1.74, 95% CI 1.05 - 1.93, P < 0.001) and all-cause death rates (HR 2.63, 95% CI 1.89 - 3.35, P < 0.001) than those with low TNF-α level subjects. Conclusions: Patients with high level of TNF-α have increased the burden of NAFLD and higher MAHE risk compared to patients with low level of TNF-α.

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