The Correlation Between hs CRP TG Triglycerides Glucose Index in NAFLD and Liver Fibrosis

Correlation Between hs CRP TG Triglycerides Glucose Index in NAFLD and Liver Fibrosis

The Correlation between hs CRP TG triglycerides Glucose index in NAFLD and liver fibrosis

Study Overview

• Status: Not yet recruiting
• Conditions: Liver Fibrosis
• Intervention / Treatment: Other: • Fasting triglycerides (TG) • Fasting plasma glucose • High-sensitivity C-reactive protein (hs-CRP) • Liver enzymes (ALT, AST, GGT) • Platelet count • HbA1c • Lipid profile (total cholesterol, HDL-C,

Detailed Description

Non-Alcoholic Fatty Liver Disease (NAFLD) is the most prevalent chronic liver disease in the world, affecting one-fourth of the global population, and represents a serious public health issue. NAFLD encompasses a broad spectrum of liver abnormalities, ranging from simple hepatic steatosis, which is thought to be benign, to non-Alcoholic Steatohepatitis (NASH) without fibrosis and progressing to fibrotic NASH. The evolution of liver fibrosis results in irreversible architectural changes of the liver and can progress to Hepatocellular Carcinoma (HCC) (Sheka et al., 2020; Zhou et al., 2025). NAFLD is associated with an increased risk of systemic metabolic disorders, such as hyperuricemia, hyperlipidemia, IR, and hyperglycemia. These metabolic disorders, in combination with NAFLD, contribute to the risk of developing extrahepatic malignancies and cardiovascular diseases, which are the main causes of extrahepatic mortality (Li et al., 2022).

High-sensitivity C-reactive protein (hs-CRP) is a widely used biomarker for measuring systemic inflammation and is readily available for measurement. It is especially useful for identifying low-grade inflammation and has been associated with adverse health outcomes, including cardiovascular disease, metabolic syndrome, insulin resistance, and decreased physical function (Banait et al., 2022; Son et al., 2022). In addition, hs-CRP is a marker of pro-inflammatory cytokines such as interleukin-6 (IL- 6) and tumor necrosis factor-alpha (TNF-α), and it has been used as a useful and valid marker of inflammation in large-scale epidemiological studies (Banait et al., 2022). In addition, the C-reactive protein-triglyceride glucose index (CTI) is a composite index that integrates the triglyceride and glucose (TyG) index with hs-CRP, thus reflecting both insulin resistance and systemic inflammation. Previous studies have found that the CTI is linked to various diseases, such as coronary heart disease, depression, stroke, NAFLD, and liver fibrosis (Ruan et al., 2022 Recent research has helped elucidate the pathogenic roles of insulin resistance (IR) and inflammation in NAFLD. Patients with non-alcoholic steatohepatitis (NASH) are likely to have higher levels of high-sensitivity C-reactive protein (hs-CRP) and pro-inflammatory cytokines, which could contribute to chronic inflammation and disease progression. Moreover, systemic inflammation is known to play a pivotal role in the pathogenesis of advanced cirrhosis (Ling et al., 2023). The triglyceride-glucose (TyG) index, a non-invasive surrogate marker of insulin resistance, is strongly linked with the development and progression of hepatic steatosis and fibrosis. The combined high-sensitivity C-reactive protein and triglyceride glucose index (CTI), which combines TyG and hs-CRP, offers a comprehensive estimate that reflects both insulin resistance and inflammation (Ruan et al., 2022; Xu et al., 2024). However, there are only a limited number of studies with a limited number of patients that have addressed the Correlation between the hs-CRP-triglyceride glucose index and NAFLD and liver fibrosis.

• Study Type: Observational
• Enrollment (Estimated): 96

Contacts and Locations

• Study Contact: Name: Nourhan Sayed Jadelrab Alsayed, Resident; Phone Number: 01156076721; Email: nouralsayed999@gmail.com
• Study Contact Backup: Name: Nourhan Sayed Jadelrab Sayed Alsayed, Resident; Phone Number: 01040888770; Email: nouralsayed999@gmail.com

Study Locations

• Egypt
  • Asyut, Egypt
    • Assiut University Hospital Assiut, Assiut Governorate
    • Contact: Nour Nourhan Sayed Jadelrab, Resident; Phone Number: 01156076721; Email: nouralsayed999@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Non-Alcoholic Fatty Liver Disease (NAFLD) is the most prevalent chronic liver disease in the world, affecting one-fourth of the global population, and represents a serious public health issue. NAFLD encompasses a broad spectrum of liver abnormalities, ranging from simple hepatic steatosis, which is thought to be benign, to non-Alcoholic Steatohepatitis (NASH) without fibrosis and progressing to fibrotic NASH. The evolution of liver fibrosis results in irreversible architectural changes of the liver and can progress to Hepatocellular Carcinoma (HCC) (Sheka et al., 2020; Zhou et al., 2025). NAFLD is associated with an increased risk of systemic metabolic disorders, such as hyperuricemia, hyperlipidemia, IR, and hyperglycemia. These metabolic disorders, in combination with NAFLD, contribute to the risk of developing extrahepatic malignancies and cardiovascular diseases, which are the main causes of extrahepatic mortality (Li et al., 2022).

High-sensitivity C-reactive protein

Description

Inclusion Criteria:

1. Adults ≥18 years
2. Available fasting labs: TG, fasting glucose, hs-CRP
3. Valid liver assessment by VCTE (FibroScan LSM) and CAP or ultrasound-based steatosis assessment

Exclusion Criteria:

• 1- Significant alcohol intake (define using your local standard; commonly sex-specific thresholds) 2- Viral hepatitis (HBsAg positive and/or HCV RNA positive) 3- Other chronic liver diseases (autoimmune hepatitis, hemochromatosis, Wilson's, etc.) 4- Pregnancy

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Participants will be instructed to fast for 8-12 hours before blood sampling. Venous blood samples w

Other: • Fasting triglycerides (TG) • Fasting plasma glucose • High-sensitivity C-reactive protein (hs-CRP) • Liver enzymes (ALT, AST, GGT) • Platelet count • HbA1c • Lipid profile (total cholesterol, HDL-C,; Participants will be instructed to fast for 8-12 hours before blood sampling. Venous blood samples will be collected in the morning and analyzed in a certified laboratory for: Fasting triglycerides (TG); Fasting plasma glucose; High-sensitivity C-reactive protein (hs-CRP); Liver enzymes (ALT, AST, GGT); Platelet count; HbA1c; Lipid profile (total cholesterol, HDL-C, LDL-C)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Presence of NAFLD (defined by CAP ≥248 dB/m after exclusion of secondary causes).	1Year

Collaborators and Investigators

• Sponsor: Assiut University
• Investigators: Principal Investigator: Essam Mohamed Abdelaziz ali, Professor; Principal Investigator: Ahmed Abdelfadeel Maghrraby hasdan, Lecturer

Publications and helpful links

General Publications

• Sheka AC, Adeyi O, Thompson J, Hameed B, Crawford PA, Ikramuddin S. Nonalcoholic Steatohepatitis: A Review. JAMA. 2020 Mar 24;323(12):1175-1183. doi: 10.1001/jama.2020.2298.
• Zhou Y,Lin H,Weng X,Dai H,Xu J
• Xu M,Zhang L,Xu D,Shi W,Zhang W
• Son DH,Song SA,Lee YJ
• Ruan GT,Xie HL,Zhang HY,Liu CA,Ge YZ,Zhang Q,Wang ZW,Zhang X,Tang M,Song MM,Zhang XW,Yang M,Chen YB,Yu KY,Deng L,Gong YZ,Hu W,Wang KH,Cong MH,Shi HP
• Ling Q,Chen J,Liu X,Xu Y,Ma J,Yu P,Zheng K,Liu F,Luo J
• Li Q,Han Y,Hu H,Zhuge Y
• Banait T,Wanjari A,Danade V,Banait S,Jain J

Study record dates

Study Major Dates

• Study Start (Estimated): October 2, 2026
• Primary Completion (Estimated): October 2, 2027
• Study Completion (Estimated): December 2, 2027

Study Registration Dates

• First Submitted: March 31, 2026
• First Submitted That Met QC Criteria: March 31, 2026
• First Posted (Actual): April 7, 2026

Study Record Updates

• Last Update Posted (Actual): April 7, 2026
• Last Update Submitted That Met QC Criteria: March 31, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Digestive System Diseases; Liver Diseases; Fibrosis; Pathological Conditions, Signs and Symptoms; Liver Cirrhosis; Amino Acids, Peptides, and Proteins; Proteins; Lipids; Polycyclic Compounds; Enzymes; Enzymes and Coenzymes; Immunoproteins; Blood Proteins; Steroids; Fused-Ring Compounds; Acute-Phase Proteins; Albumins; Transaminases; Nitrogenous Group Transferases; Transferases; Cholestenes; Cholestanes; Sterols; Membrane Lipids; Acyltransferases; Aminoacyltransferases; Alanine Transaminase; Cholesterol; gamma-Glutamyltransferase; C-Reactive Protein
• Other Study ID Numbers: hs CRP TG Glucose index

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No