TY - JOUR
T1 - The impact of insulin resistance, serum adipocytokines and visceral obesity on steatosis and fibrosis in patients with chronic hepatitis C.
AU - Craxi, Antonio
AU - Almasio, Pier Luigi
AU - Ferraro, Donatella
AU - Rodolico, Vito
AU - Giordano, Carla
AU - Di Marco, Vito
AU - Amato, Marco Calogero
AU - Lo Iacono, null
PY - 2007
Y1 - 2007
N2 - Aims
To assess whether host metabolic factors influence the degree of hepatic
steatosis and fibrosis in patients infected with hepatitis C virus, and to
evaluate the impact of anti-viral therapy on insulin resistance and
serum levels of adipocytokines.
Methods
Clinical and biochemical features, anthropometrical characteristics, and
levels of fasting insulin, leptin, adiponectin and resistin were measured
in ‘naı¨ve’ patients with chronic hepatitis C, before, during and after
therapy with Peg-Interferon-alpha 2a plus Ribavirin.
Results
Forty-eight patients were included (M/F 28/20;meanage 50.0 12.6 years;
62.5% genotype-1). Body mass index was 26.4 4.0 kg/m2, and visceral
obesity was present in 24 patients. At multivariate analysis (RR; 95% CI),
steatosis was associated to older age (1.08; 1–1.18), necroinflammatory
activity (17.67; 1.6–194.46), and raised insulin levels (1.39; 1.1–1.77).
Fibrosis was related to necroinflammatory activity (25.73; 2.54–261.11),
and steatosis (6.47; 1.09–38.29). Sustained viral response was achieved by
62.5% of patients and was associated with younger age (0.92; 0.85–0.99),
genotype non-1 (10.61; 1.52–73.76) and absence of visceral obesity (13.78;
2.36–80.29). At the end of follow-up, insulin and the homeostasis model
assesment for insulin resistance were reduced and adiponectin increased
when compared with baseline, all unrelated to the outcome of treatment.
Conclusions
Visceral obesity correlates with the degree of steatosis and fibrosis, and
it negatively affects treatment response. Significant changes of insulin
resistance and adipocytokines occur under treatment, irrespective of virological
outcome.
AB - Aims
To assess whether host metabolic factors influence the degree of hepatic
steatosis and fibrosis in patients infected with hepatitis C virus, and to
evaluate the impact of anti-viral therapy on insulin resistance and
serum levels of adipocytokines.
Methods
Clinical and biochemical features, anthropometrical characteristics, and
levels of fasting insulin, leptin, adiponectin and resistin were measured
in ‘naı¨ve’ patients with chronic hepatitis C, before, during and after
therapy with Peg-Interferon-alpha 2a plus Ribavirin.
Results
Forty-eight patients were included (M/F 28/20;meanage 50.0 12.6 years;
62.5% genotype-1). Body mass index was 26.4 4.0 kg/m2, and visceral
obesity was present in 24 patients. At multivariate analysis (RR; 95% CI),
steatosis was associated to older age (1.08; 1–1.18), necroinflammatory
activity (17.67; 1.6–194.46), and raised insulin levels (1.39; 1.1–1.77).
Fibrosis was related to necroinflammatory activity (25.73; 2.54–261.11),
and steatosis (6.47; 1.09–38.29). Sustained viral response was achieved by
62.5% of patients and was associated with younger age (0.92; 0.85–0.99),
genotype non-1 (10.61; 1.52–73.76) and absence of visceral obesity (13.78;
2.36–80.29). At the end of follow-up, insulin and the homeostasis model
assesment for insulin resistance were reduced and adiponectin increased
when compared with baseline, all unrelated to the outcome of treatment.
Conclusions
Visceral obesity correlates with the degree of steatosis and fibrosis, and
it negatively affects treatment response. Significant changes of insulin
resistance and adipocytokines occur under treatment, irrespective of virological
outcome.
KW - insulin resistance; hepatitic C; metabolism
UR - http://hdl.handle.net/10447/60580
M3 - Article
VL - 25
SP - 1181
EP - 1191
JO - Alimentary Pharmacology and Therapeutics
JF - Alimentary Pharmacology and Therapeutics
SN - 0269-2813
ER -