Neuro-immune and metabolic disorders in association with depression, anxiety, and chronic fatigue-fibromyalgia symptoms due to non-alcoholic fatty liver disease
Walaa Abdulhussein Al-Azzawi, Hamid Yaghooti, Hussein Kadhem A-Hakeim, Michael Maes
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Background
Nonalcoholic fatty liver disease (NAFLD) is frequently associated with depression, anxiety, and chronic fatigue syndrome (CFS). Major depression and NAFLD are accompanied by low-grade inflammation, increased atherogenicity and insulin resistance.
There is a paucity of data on serum tryptophan and tryptophan catabolites (TRYCATs) in relation to these symptoms in patients with NAFLD. The aim of this study is to determine the relationships between the severity of NAFLD, severity of the above neuropsychiatric symptoms and neuro-immune, metabolic and TRYCAT pathway biomarkers.
Methods
This case-control study included fifty-six Grade 1 NAFLD patients, fifty-two Grade 2 NAFLD patients, and 60 healthy controls. We assessed serum insulin, tryptophan, kynurenine, 3-hydroxykynurenine, kynurenic acid, indoleamine 2, 3-dioxygenase 1 (IDO1), Interleukin (IL)-6, IL-10, the HOMA2 insulin resistance (HOMA2IR), and atherogenity indices.
Results
The severity of depression, anxiety, and CFS was significantly higher in NAFLD than in controls, and in grade 2 as compared with grade 1 NAFLD. The atherogenic and HOMA2IR indices significantly increased from controls to grade 1 to grade 2.
Serum tryptophan, kynurenine, kynurenic acid, and 3-OH-kynurenine were significantly lower in NAFLD and especially in Grade 2 than in controls, while IL-6 and IL-10 were higher in grade 2 NAFLD than in controls. The rating scale scores were significantly and positively correlated with liver tests, atherogenicity and HOMA2 indices, and inversely with tryptophan and TRYCATs.
Conclusions
Affective and CFS symptoms due to NAFLD might be mediated by the cumulative neurotoxic effects of lipids, IR, and lowered anti-inflammatory and antioxidant effects of the TRYCAT pathway.
Link | PDF (Preprint: ResearchGate) [Open Access]
Walaa Abdulhussein Al-Azzawi, Hamid Yaghooti, Hussein Kadhem A-Hakeim, Michael Maes
[Line breaks added]
Background
Nonalcoholic fatty liver disease (NAFLD) is frequently associated with depression, anxiety, and chronic fatigue syndrome (CFS). Major depression and NAFLD are accompanied by low-grade inflammation, increased atherogenicity and insulin resistance.
There is a paucity of data on serum tryptophan and tryptophan catabolites (TRYCATs) in relation to these symptoms in patients with NAFLD. The aim of this study is to determine the relationships between the severity of NAFLD, severity of the above neuropsychiatric symptoms and neuro-immune, metabolic and TRYCAT pathway biomarkers.
Methods
This case-control study included fifty-six Grade 1 NAFLD patients, fifty-two Grade 2 NAFLD patients, and 60 healthy controls. We assessed serum insulin, tryptophan, kynurenine, 3-hydroxykynurenine, kynurenic acid, indoleamine 2, 3-dioxygenase 1 (IDO1), Interleukin (IL)-6, IL-10, the HOMA2 insulin resistance (HOMA2IR), and atherogenity indices.
Results
The severity of depression, anxiety, and CFS was significantly higher in NAFLD than in controls, and in grade 2 as compared with grade 1 NAFLD. The atherogenic and HOMA2IR indices significantly increased from controls to grade 1 to grade 2.
Serum tryptophan, kynurenine, kynurenic acid, and 3-OH-kynurenine were significantly lower in NAFLD and especially in Grade 2 than in controls, while IL-6 and IL-10 were higher in grade 2 NAFLD than in controls. The rating scale scores were significantly and positively correlated with liver tests, atherogenicity and HOMA2 indices, and inversely with tryptophan and TRYCATs.
Conclusions
Affective and CFS symptoms due to NAFLD might be mediated by the cumulative neurotoxic effects of lipids, IR, and lowered anti-inflammatory and antioxidant effects of the TRYCAT pathway.
Link | PDF (Preprint: ResearchGate) [Open Access]
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