Metabolic syndrome is associated with severe fibrosis in chronic viral hepatitis and non-alcoholic s

December 15, 2007

Alimentary Pharmacology & Therapeutics 27 (1), 80–89.

doi:10.1111/j.1365-2036.2007.03538.x

Abstract

Metabolic syndrome is associated with severe fibrosis in chronic viral hepatitis

and non-alcoholic steatohepatitis

E. TSOCHATZIS**2nd Department of Internal Medicine, Athens University Medical

School, Hippokration General Hospital, Athens, G. V. PAPATHEODORIDIS**2nd

Department of Internal Medicine, Athens University Medical School, Hippokration

General Hospital, Athens, E. K. MANESIS**2nd Department of Internal Medicine,

Athens University Medical School, Hippokration General Hospital, Athens, G.

KAFIRI††Department of Pathology, Hippokration General Hospital, Athens, D. G.

TINIAKOS‡‡Laboratory of Histology & Embryology, Athens University Medical

School, Athens, Greece & A. J. ARCHIMANDRITIS**2nd Department of Internal

Medicine, Athens University Medical School, Hippokration General Hospital,

Athens*2nd Department of Internal Medicine, Athens University Medical School,

Hippokration General Hospital, Athens; †Department of Pathology, Hippokration

General Hospital, Athens; ‡Laboratory of Histology & Embryology, Athens

University Medical School, Athens, Greece

Dr G. V. Papatheodoridis, 2nd Department of Internal Medicine, Athens University

Medical School, Hippokration General Hospital of Athens, 114 Vas. Sophias Ave,

115 27 Athens, Greece.

E-mail: gepapath@...

Summary

Background The prevalence of metabolic syndrome and its possible impact on the

severity of liver histological lesions have not been studied prospectively in

chronic liver diseases.

Aim To investigate the prevalence of metabolic syndrome in patients with chronic

viral hepatitis or non-alcoholic steatohepatitis, and to determine its

associations with histological severity.

Methods We prospectively included 317 patients (hepatitis B e antigen-negative

chronic hepatitis B: 95, chronic hepatitis C: 176, non-alcoholic

steatohepatitis: 46) with liver biopsy. Metabolic syndrome was defined using the

Adult Treatment Panel III criteria. Histological lesions were evaluated

according to Ishak’s or Brunt’s classification.

Results Metabolic syndrome was present in 10.4% of patients being significantly

more prevalent in non-alcoholic steatohepatitis than in chronic viral hepatitis

(41.3% vs. 5.1%, P < 0.001). In chronic viral hepatitis, cirrhosis (stages 5–6)

was independently associated with increasing age, higher aspartate

aminotransferase and gamma-glutamyl-transpeptidase levels, severe

necroinflammation and metabolic syndrome (P = 0.016). In non-alcoholic

steatohepatitis, severe fibrosis (stages 3–4) was independently associated with

severe necroinflammation and metabolic syndrome (P = 0.033). Presence of

metabolic syndrome was not associated with presence or severity of steatosis

both in chronic viral hepatitis and in non-alcoholic steatohepatitis.

Conclusion Metabolic syndrome is more prevalent in non-alcoholic steatohepatitis

than in chronic viral hepatitis; it is associated independently with more severe

fibrosis but not with the severity of steatosis, both in chronic viral hepatitis

and in non-alcoholic steatohepatitis.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2036.2007.03538.x

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December 15, 2007