Chronic HCV infection is a risk of atherosclerosis. Role of HCV and HCV-related steatosis
Chronic HCV infection is a risk of atherosclerosis. Role of HCV and HCV-related steatosis
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DOI：
10.1016/j.atherosclerosis.2012.01.051
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发表时间：
2012-04-01
期刊：
影响因子：
5.3
通讯作者：
Florio, Anna
中科院分区：
文献类型：
--
作者：
Adinolfi, Luigi E.;Restivo, Luciano;Florio, Anna
目的：HCV 和 NAFLD 与普通人群的动脉粥样硬化有关。慢性丙型肝炎 (CHC) 患者中动脉粥样硬化的患病率尚不清楚。我们假设 HCV 本身和 HCV 相关的脂肪变性可能有利于动脉粥样硬化。因此，在 CHC 患者中，我们评估了： (a) 动脉粥样硬化的患病率； (b) HCV、心脏代谢危险因素和肝脏组织学的作用。 方法：总体而言，纳入了 803 名受试者：(A) 326 名经肝活检证实患有初治 CHC 的患者（175 名患有脂肪变性，151 名未患有脂肪变性）； (B) 477 名年龄和性别匹配的对照者，包括 292 名无脂肪变性的健康受试者 (B1) 和 185 名患有 NAFLD 的健康受试者 (B2)。通过高分辨率 B 型超声检查评估颈动脉粥样硬化 (CA)，将其分为内膜中层厚度 (IMT：> 1 mm) 或斑块 (>= 1.5 mm)。 结果：CHC 患者的 CA 患病率高于对照组（53.7% vs 34.3%；p < 0.0001）。年轻 CHC（< 50 岁）的 CA 患病率高于对照组（34.0% vs 16.0%；p < 0.04）。无脂肪变性的 CHC 患者的 CA 患病率高于 B1 对照组（26.0% vs 14.8%；p < 0.02）。伴有脂肪变性的 CHC 患者的 CA 患病率高于 NAFLD 患者（77.7% vs 57.8%，p < 0.0001）。病毒载量与血清 CRP 和纤维蛋白原水平相关；脂肪变性伴代谢综合征、HOMA-IR、高同型半胱氨酸血症和肝纤维化。病毒载量和脂肪变性与 CA 独立相关。糖尿病和代谢综合征与斑块相关。 结论：HCV 感染是通过病毒载量和脂肪变性调节炎症和代谢异常环境等致动脉粥样硬化因素而促进 CA 早期发生的危险因素。 (C) 2012 年，爱思唯尔爱尔兰有限公司出版。
Objectives: HCV and NAFLD are associated with atherosclerosis in general population. The prevalence of atherosclerosis in chronic hepatitis C (CHC) patients is unknown. We hypothesized that HCV per se and HCV-related steatosis could favour atherosclerosis. Thus, in CHC patients we assessed: (a) the prevalence of atherosclerosis; (b) the role of HCV, cardio-metabolic risk factors and hepatic histology.Methods: Overall, 803 subjects were enrolled: (A) 326 patients with liver biopsy-proven treatment naive CHC (175 with and 151 without steatosis); (B) 477 age and gender matched controls, including 292 healthy subjects without steatosis (B1) and 185 with NAFLD (B2). Carotid atherosclerosis (CA), assessed by high-resolution B-mode ultrasonography, was categorized as either intima-media thickness (IMT: > 1 mm) or plaques (>= 1.5 mm).Results: CHC patients had a higher prevalence of CA than controls (53.7% vs 34.3%; p < 0.0001). Younger CHC (< 50 years) had a higher prevalence of CA than controls (34.0% vs 16.0%; p < 0.04). CHC patients without steatosis had a higher prevalence of CA than B1 controls (26.0% vs 14.8%; p < 0.02). CHC with steatosis had a higher prevalence of CA than NAFLD patients (77.7% vs 57.8%, p < 0.0001). Viral load was associated with serum CRP and fibrinogen levels; steatosis with metabolic syndrome, HOMA-IR, hyperhomocysteinemia and liver fibrosis. Viral load and steatosis were independently associated with CA. Diabetes and metabolic syndrome were associated with plaques.Conclusion: HCV infection is a risk factor for earlier and facilitated occurrence of CA via viral load and steatosis which modulate atherogenic factors such as inflammation and dysmetabolic milieu. (C) 2012 Published by Elsevier Ireland Ltd.