The impact of insulin resistance, serum adipocytokines and visceral obesity on steatosis and fibrosis in patients with chronic hepatitis C.

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Abstract

AimsTo assess whether host metabolic factors influence the degree of hepaticsteatosis and fibrosis in patients infected with hepatitis C virus, and toevaluate the impact of anti-viral therapy on insulin resistance andserum levels of adipocytokines.MethodsClinical and biochemical features, anthropometrical characteristics, andlevels of fasting insulin, leptin, adiponectin and resistin were measuredin ‘naı¨ve’ patients with chronic hepatitis C, before, during and aftertherapy with Peg-Interferon-alpha 2a plus Ribavirin.ResultsForty-eightpatientswereincluded(M/F28/20;meanage50.0 12.6years;62.5% genotype-1). Body mass index was 26.4 4.0 kg/m2, and visceralobesity was present in 24 patients. At multivariate analysis (RR; 95% CI),steatosis was associated to older age (1.08; 1–1.18), necroinflammatoryactivity (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 by62.5% 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 modelassesment for insulin resistance were reduced and adiponectin increasedwhencompared withbaseline,all unrelatedtotheoutcome oftreatment.ConclusionsVisceral obesity correlates with the degree of steatosis and fibrosis, andit negatively affects treatment response. Significant changes of insulinresistance and adipocytokines occur under treatment, irrespective of virologicaloutcome.
Lingua originaleEnglish
pagine (da-a)1181-1191
Numero di pagine11
RivistaALIMENTARY PHARMACOLOGY & THERAPEUTICS
Volume25
Stato di pubblicazionePublished - 2007

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

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