Steatosis accelerates the progression of liver damage of chronic hepatitis C patients and correlates with specific HCV genotype and visceral obesity
Steatosis accelerates the progression of liver damage of chronic hepatitis C patients and correlates with specific HCV genotype and visceral obesity
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DOI：
10.1053/jhep.2001.24432
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发表时间：
2001-06-01
期刊：
影响因子：
13.5
通讯作者：
Ruggiero, G
中科院分区：
文献类型：
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作者：
Adinolfi, LE;Gambardella, M;Ruggiero, G
探讨脂肪变性在慢性丙型肝炎(CHC)肝损害进展中的作用。研究对象为180名连续接受肝活检证实的慢性丙型肝炎患者和41名感染持续时间已知的受试者。我们评估了组织学活动指数(HAI)、纤维化和脂肪变性分级、体重指数(BMI；kg/m(2))、体脂分布、丙型肝炎病毒基因型别和丙型肝炎病毒核糖核酸水平。86例(48%)患者出现脂肪变性，且3a型感染的患病率较高(P<；.01)，脂肪变性程度与肝纤维化程度相关(P<；.001)。纤维化也与年龄有关(P<；.001)。在调整了年龄后，脂肪变性和纤维化之间的关联仍然显著。脂肪变性的程度也与HAI相关(P<；0.007)，门脉周围坏死显著增加。未发现脂肪变性与年龄、性别、铁储存或丙型肝炎病毒RNA水平之间的关系。脂肪变性程度高的患者(30%)表现出较高的血清γ-GT和ALT水平(P<；.001)，总体而言，脂肪变性与BMI没有明显的关联。单基因分析显示脂肪变性程度与1型感染的BMI显著相关(r=.689；P<；.001)，与3a型感染的丙型肝炎病毒RNA水平显著相关(r=.786；P
The role of steatosis in the progression of liver damage in chronic hepatitis C (CHC) was studied. Enrolled were 180 consecutive liver biopsy-proven CHC patients and 41 additional subjects with a known duration of infection. We evaluated the histological activity index (HAI), grade of fibrosis and steatosis, body mass index (BMI; kg/m(2)), distribution of body fat, HCV genotype, and levels of HCV RNA. Eighty six (48%) patients showed steatosis, and a higher prevalence was observed in genotype 3a infection (P < .01), A correlation between the grade of steatosis and fibrosis was observed (P < .001). Fibrosis was also associated with age (P < .001). After adjusting for age, the association between steatosis and fibrosis remained significant. The grade of steatosis also correlated with the HAI (P < .007) with a significant increase in periportal necrosis. No relation was found between steatosis and age, gender, iron storage, or levels of HCV RNA. Patients with a high grade of steatosis (>30%) showed higher serum levels of gamma -GT and ALT (P < .001), Overall, steatosis was not significantly associated to BMI. Analysis by single genotype showed a significant association between the grade of steatosis and BMI in type 1 infection r = .689; P < .001) and with levels of HCV RNA in type 3a infection r = .786; P