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



Tejareh F ; Payahoo L ; Keshavarz SA
Source: Endocrinology, Diabetes and Metabolism Published:2026

Abstract

Background: 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). Patients and Methods: 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. Results: 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). Conclusion: 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. © 2026 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.