Oxidative Stress Induced Liver Damage in Dengue Is Exacerbated in Those With Obesity

As there are limited data on the association of obesity with liver dysfunction and oxidative stress in patients with acute Dengue, we investigated liver dysfunction associated with obesity, oxidative stress, and inflammatory markers in a large cohort of patients with varying severity of illness.

Five hundred seventy-seven adults with a duration of illness ≤4 days at time of admission were followed up from admission to discharge. Aspartate transaminase (AST), alanine transaminase (ALT), C-reactive protein, ferritin, 4-hydroxynonenal (4-HNE), and malondialdehyde (MDA) levels were measured, along with the height, weight, and waist circumference.

AST, ALT, CRP, and ferritin levels were significantly higher in patients with central obesity (waist circumference of ≥80 cm in women or ≥90 cm in men) compared with leaner individuals. ALT and CRP levels were also significantly higher in patients with a body mass index (BMI) of ≥23.9 kg/m². 4-HNE levels significantly increased with the rise in AST levels and with ALT levels, although the increase was not significant. In contrast, MDA levels gradually decreased with the rise in AST levels and ALT levels. There were no differences in 4-HNE and MDA levels in relation to clinical disease severity. However, MDA levels were significantly higher in younger individuals and leaner individuals with a normal BMI. Furthermore, MDA levels inversely correlated with serum ferritin levels, while AST, ALT, and CRP levels significantly correlated with ferritin levels.

4-HNE and MDA appear to play different roles in the pathogenesis of Dengue, which should be further investigated for identification of therapeutic targets for treatment of Dengue.