Alcohol, obesity, and TNF-α

Editor,—The conclusions reached by Wigg et al ( (2001) Gut 48:206–11. [OpenUrl][1][Abstract/FREE Full Text][2] ) about the origin and importance of tumour necrosis factor α (TNF-α) in non-alcoholic steatohepatitis (NASH) patients have failed to take into account the relationship between even modest alcohol consumption and TNF-α production and function. The authors found a lack of correlation between obesity and TNF-α levels in NASH patients and concluded that TNF-α, which they see as central to the pathogenesis of the condition, must have other sources. We first described the strong correlation between obesity and serum TNF-α in 1998.1 Adipose tissue synthesises a number of proinflammatory cytokines.2 The negative correlation found in the Adelaide study is surprising given the findings in larger studies of non-NASH subjects and may be due to the small study numbers and not correcting for modest alcohol intake. Alcohol consumption is considered a risk factor for the development and progression of liver disease in patients with fatty livers. We previously showed a strong negative correlation between any alcohol … Dr AJ Wigg, Department of Gastroenterology and Hepatology, Flinders Medical Centre, Bedford Park, SA 5042, Australia.alan.wigg{at}flinders.edu.au [1]: {openurl}?query=rft.jtitle%253DHeart%26rft.stitle%253DHeart%26rft.issn%253D0007-0769%26rft.aulast%253DMendall%26rft.auinit1%253DM.%2BA.%26rft.volume%253D78%26rft.issue%253D3%26rft.spage%253D273%26rft.epage%253D277%26rft.atitle%253DRelation%2Bof%2Bserum%2Bcytokine%2Bconcentrations%2Bto%2Bcardiovascular%2Brisk%2Bfactors%2Band%2Bcoronary%2Bheart%2Bdisease.%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fhrt.78.3.273%26rft_id%253Dinfo%253Apmid%252F9391290%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=heartjnl&resid=78/3/273&atom=%2Fgutjnl%2F49%2F2%2F313.atom