Association of metabolic profiles with hepatic fibrosis in chronic hepatitis C patients with genotype 1 or 2 infection

[Guest guest]

http://www3.interscience.wiley.com/journal/122687086/abstract

Journal of Gastroenterology and Hepatology

Volume 25 Issue 5, Pages 970 - 977

Published Online: 18 Nov 2009

Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd and Journal of

Gastroenterology and Hepatology Foundation

HEPATOLOGY

Association of metabolic profiles with hepatic fibrosis in chronic hepatitis C

patients with genotype 1 or 2 infection

Ching-Sheng Hsu,*† Chen-Hua Liu, †‡ Chun-Jen Liu, †‡ Shih-Jer Hsu, †§ Chi-Ling

Chen, † Juey-Jen Hwang, § Ming-Yang Lai, †‡¶ Pei-Jer Chen, †‡¶ Ding-Shinn Chen

†‡ and Jia-Horng Kao †‡¶**

*Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi

General Hospital, Taipei Branch, and School of Medicine, Tzu Chi University,

Hualien, Taiwan, † Graduate Institute of Clinical Medicine, ‡ Department of

Internal Medicine, National Taiwan University Hospital, ¶ Department of

Medical Research, and **Hepatitis Research Center, National Taiwan University

College of Medicine and National Taiwan University Hospital, Taipei, and §

Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin

Branch, Yun-Lin County, Taiwan

Correspondence to Professor Jia-Horng Kao, Director and Distinguished

Professor, Graduate Institute of Clinical Medicine, National Taiwan University

College of Medicine, 7 Chung-Shan South Road, Taipei 10002, Taiwan. Email:

kaojh@...

Grant/Funding Support: This work was supported by grants from the National

Taiwan University Hospital, National Taiwan University Hospital Yun-Lin Branch,

Liver Disease Prevention & Treatment Research Foundation, the Department of

Health, and the National Science Council, Executive Yuan, Taiwan.

Financial Disclosures: n/a.

Potential conflicts of interest: All authors: none.

Copyright Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd and

Journal of Gastroenterology and Hepatology Foundation

ABSTRACT

Background and Aims: Metabolic profiles are associated with severity of liver

histology in chronic hepatitis C (CHC) infection. However, the influence of

hepatitis C virus (HCV) genotypes, especially genotype 1 and 2, on the

association between metabolic profiles and hepatic fibrosis remains unknown.

Methods: We consecutively enrolled 528 CHC patients infected by HCV genotype 1

or 2, and used univariate and multivariate approaches to determine the influence

of HCV genotype on the association of metabolic characteristics with severity of

liver histology.

Results: In univariate analysis, diabetes mellitus, obesity, higher grades of

hepatic steatosis, homeostasis model assessment–insulin resistance index and

alanine aminotransferase level, but lower serum total cholesterol and

low-density lipoprotein level, were associated with advanced hepatic fibrosis.

Advanced hepatic fibrosis was associated with an adjusted odds ratio of 13.72

(95% confidence interval, 2.15–87.7) for serum fasting blood glucose, 1.07 (1.01

to 1.13) for body mass index (BMI), and 0.03 (0.00–0.32) for total cholesterol

level. Older age, lower serum total cholesterol level and more

necro-inflammatory activity were associated with advanced hepatic fibrosis in

both genotype 1 and 2 patients (P < 0.05). Advanced hepatic fibrosis was

associated with an adjusted odds ratio of 31.18 (2.31–421.4) for fasting blood

glucose level in genotype 1 infection, whereas 1.16 (1.05–1.28) for BMI in

genotype 2 infection.

Conclusions: Age, serum total cholesterol, and hepatic necro-inflammation have

important associations with severity of hepatic fibrosis in CHC patients.

Moreover, these associations are different between HCV genotype: the effects of

fasting blood glucose level and BMI are increased on genotype 1 and genotype 2

patients, respectively.

--------------------------------------------------------------------------------

Accepted for publication 9 November 2009.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1440-1746.2009.06186

[Guest guest]

http://www3.interscience.wiley.com/journal/122687086/abstract

Journal of Gastroenterology and Hepatology

Volume 25 Issue 5, Pages 970 - 977

Published Online: 18 Nov 2009

Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd and Journal of

Gastroenterology and Hepatology Foundation

HEPATOLOGY

Association of metabolic profiles with hepatic fibrosis in chronic hepatitis C

patients with genotype 1 or 2 infection

Ching-Sheng Hsu,*† Chen-Hua Liu, †‡ Chun-Jen Liu, †‡ Shih-Jer Hsu, †§ Chi-Ling

Chen, † Juey-Jen Hwang, § Ming-Yang Lai, †‡¶ Pei-Jer Chen, †‡¶ Ding-Shinn Chen

†‡ and Jia-Horng Kao †‡¶**

*Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi

General Hospital, Taipei Branch, and School of Medicine, Tzu Chi University,

Hualien, Taiwan, † Graduate Institute of Clinical Medicine, ‡ Department of

Internal Medicine, National Taiwan University Hospital, ¶ Department of

Medical Research, and **Hepatitis Research Center, National Taiwan University

College of Medicine and National Taiwan University Hospital, Taipei, and §

Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin

Branch, Yun-Lin County, Taiwan

Correspondence to Professor Jia-Horng Kao, Director and Distinguished

Professor, Graduate Institute of Clinical Medicine, National Taiwan University

College of Medicine, 7 Chung-Shan South Road, Taipei 10002, Taiwan. Email:

kaojh@...

Grant/Funding Support: This work was supported by grants from the National

Taiwan University Hospital, National Taiwan University Hospital Yun-Lin Branch,

Liver Disease Prevention & Treatment Research Foundation, the Department of

Health, and the National Science Council, Executive Yuan, Taiwan.

Financial Disclosures: n/a.

Potential conflicts of interest: All authors: none.

Copyright Journal compilation © 2010 Blackwell Publishing Asia Pty Ltd and

Journal of Gastroenterology and Hepatology Foundation

ABSTRACT

Background and Aims: Metabolic profiles are associated with severity of liver

histology in chronic hepatitis C (CHC) infection. However, the influence of

hepatitis C virus (HCV) genotypes, especially genotype 1 and 2, on the

association between metabolic profiles and hepatic fibrosis remains unknown.

Methods: We consecutively enrolled 528 CHC patients infected by HCV genotype 1

or 2, and used univariate and multivariate approaches to determine the influence

of HCV genotype on the association of metabolic characteristics with severity of

liver histology.

Results: In univariate analysis, diabetes mellitus, obesity, higher grades of

hepatic steatosis, homeostasis model assessment–insulin resistance index and

alanine aminotransferase level, but lower serum total cholesterol and

low-density lipoprotein level, were associated with advanced hepatic fibrosis.

Advanced hepatic fibrosis was associated with an adjusted odds ratio of 13.72

(95% confidence interval, 2.15–87.7) for serum fasting blood glucose, 1.07 (1.01

to 1.13) for body mass index (BMI), and 0.03 (0.00–0.32) for total cholesterol

level. Older age, lower serum total cholesterol level and more

necro-inflammatory activity were associated with advanced hepatic fibrosis in

both genotype 1 and 2 patients (P < 0.05). Advanced hepatic fibrosis was

associated with an adjusted odds ratio of 31.18 (2.31–421.4) for fasting blood

glucose level in genotype 1 infection, whereas 1.16 (1.05–1.28) for BMI in

genotype 2 infection.

Conclusions: Age, serum total cholesterol, and hepatic necro-inflammation have

important associations with severity of hepatic fibrosis in CHC patients.

Moreover, these associations are different between HCV genotype: the effects of

fasting blood glucose level and BMI are increased on genotype 1 and genotype 2

patients, respectively.

--------------------------------------------------------------------------------

Accepted for publication 9 November 2009.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1440-1746.2009.06186