Steatosis in chronic hepatitis C: Relative contributions of obesity, diabetes mellitus, and alcohol
Steatosis in chronic hepatitis C: Relative contributions of obesity, diabetes mellitus, and alcohol
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DOI：
10.1053/jhep.2002.35064
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发表时间：
2002-09-01
期刊：
影响因子：
13.5
通讯作者：
Wright, TL
中科院分区：
文献类型：
--
作者：
Monto, A;Alonzo, J;Wright, TL
脂肪变性是丙型肝炎病毒相关性肝病发展过程中的一个重要的组织学发现。然而，大多数关于丙型肝炎相关性脂肪变性的研究都排除了饮酒者和糖尿病患者，因此没有解决已知的脂肪变性原因在丙型肝炎相关疾病中对肝脏损伤的相对贡献。为了解决这个问题，我们研究了297名符合纳入标准的丙型肝炎患者。饮酒、人口统计学和血清学测试与肝脏活检中脂肪变性和纤维化的程度相关。肝活检标本也被检查是否有明显的酒精性或非酒精性脂肪性肝炎(NASH)损伤的证据。在单变量分析中，脂肪变性与2型糖尿病(P=0.005)和体重指数(BMI)(P=0.0001)相关，但与酒精摄入量(以克/天为单位)无关。在多因素分析中，BMI(P=.0002)和3a型感染(P=0.02)是脂肪变性的独立预测因素。排除有NASH危险因素的患者后，3a基因感染是脂肪变性的唯一独立预测因子。脂肪变性(P=0.04)和炎症(P
Steatosis has emerged as a histologic finding of importance to the progression of hepatitis C virus (HCV)-associated liver disease. However, most studies of HCV-associated steatosis have excluded alcohol drinkers and individuals with diabetes and thus have not addressed the relative contribution of known causes of steatosis to liver injury in HCV-associated disease. To address this issue, we studied 297 consecutive patients with HCV who met inclusion criteria. Alcohol consumption, demographics, and serologic tests were correlated with degrees of steatosis and fibrosis on liver biopsy. Liver biopsy specimens were also examined for evidence of significant alcohol or nonalcoholic steatohepatitis (NASH) injury. In univariate analysis, steatosis correlated with type 2 diabetes mellitus (P =.005) and body mass index (BMI) (P =.0001) but not with the intensity of alcohol intake (in grams per day). In multivariate analysis, BMI (P =.0002) and genotype 3a infection (P =.02) were independent predictors of steatosis. When patients with risk factors for NASH were excluded, genotype 3a infection was the only independent predictor of steatosis. Steatosis (P =.04) and inflammation (P