Effects of Metabolic Syndrome on Fibrosis in Chronic Viral Hepatitis
0
조회
0
다운로드
0
인용
0
참고문헌
초록
Background/Aims: Metabolic syndrome, comprising diabetes,hypertension, central obesity, and dyslipidemia, is increasingly prevalent worldwide. We aimed to study the relationship between metabolic syndrome and the risk of liver fibrosis in patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC). Methods: In total, 954 patients (CHB,850; CHC, 104 patients) with liver biopsy were included in the retrospective analysis. Extensive clinical and histological data were available. Metabolic syndrome was defined using the International Diabetes Federation definition of metabolic syndrome, 2006 criteria. Histological lesions were evaluated according to the histology activity index system. Results: Metabolic syndrome was present in 6% of patients and significantly more prevalent in patients with CHC than in patients with CHB (5% vs 13%, p<0.001). Patients with metabolic syndrome were older among patients with CHB and patients with CHC, and, as expected, were mainly overweight or obese. Fibrosis was significantly more severe in patients with metabolic syndrome than in those without, regardless of whether they had CHB and CHC (CHB, 3.3±2.1 vs 2.4±1.3, p=0.025; CHC, 2.6±1.5 vs 1.3±0.7, p=0.006). Liver fibrosis (stages 3 to 4) was independently associated with increased age, higher transaminase level and metabolic syndrome (odds ratio, 2.421; p=0.017). Conclusions: Metabolic syndrome is associated independently with severe fibrosis in patients with chronic viral hepatitis B and C.
Abstract
Background/Aims: Metabolic syndrome, comprising diabetes,hypertension, central obesity, and dyslipidemia, is increasingly prevalent worldwide. We aimed to study the relationship between metabolic syndrome and the risk of liver fibrosis in patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC). Methods: In total, 954 patients (CHB,850; CHC, 104 patients) with liver biopsy were included in the retrospective analysis. Extensive clinical and histological data were available. Metabolic syndrome was defined using the International Diabetes Federation definition of metabolic syndrome, 2006 criteria. Histological lesions were evaluated according to the histology activity index system. Results: Metabolic syndrome was present in 6% of patients and significantly more prevalent in patients with CHC than in patients with CHB (5% vs 13%, p<0.001). Patients with metabolic syndrome were older among patients with CHB and patients with CHC, and, as expected, were mainly overweight or obese. Fibrosis was significantly more severe in patients with metabolic syndrome than in those without, regardless of whether they had CHB and CHC (CHB, 3.3±2.1 vs 2.4±1.3, p=0.025; CHC, 2.6±1.5 vs 1.3±0.7, p=0.006). Liver fibrosis (stages 3 to 4) was independently associated with increased age, higher transaminase level and metabolic syndrome (odds ratio, 2.421; p=0.017). Conclusions: Metabolic syndrome is associated independently with severe fibrosis in patients with chronic viral hepatitis B and C.
참고문헌 (24)
- Eckel RH, "The metabolic syndrome", Lancet, 375, pp.181~183 (2010)
- Schaffler A, "Mechanisms of disease: adipocytokines and visceral adipose tissue: emerging role in nonalcoholic fatty liver disease", Nat Clin Pract Gastroenterol Hepatol, 2, pp.273~280 (2005)
- Wong VW, "Metabolic and adipokine profile of Chinese patients with nonalcoholic fatty liver disease", Gastroenterol Hepatol, 4, pp.1154~1161 (2006)
- Tsochatzis E, "Serum adipokine levels in chronic liver diseases: association of resistin levels with fibrosis severity", Scand J Gastroenterol, 43, pp.1128~1136 (2008)
- Wong VW, "Clinical and histological features of non-alcoholic fatty liver disease in Hong Kong Chinese", Aliment Pharmacol Ther, 20, pp.45~49 (2004)
- Nugent C, "Evaluation and management of obesity-related nonalcoholic fatty liver disease", Nat Clin Pract Gastroenterol Hepatol, 4, pp.432~441 (2007)
- Hossain N, "Independent predictors of fibrosis in patients with nonalcoholic fatty liver disease", Clin Gastroenterol Hepatol, 7, pp.1224~1229 (2009)
- Angulo P, "NAFLD fibrosis score: a noninvasive system that identifies liver fibrosis in patients with NAFLD", Hepatology, 45, pp.846~854 (2007)
- Byrne CD, "Metabolic disturbances in non-alcoholic fatty liver disease", Clin Sci (Lond), 116, pp.539~564 (2009)
- Elgouhari HM, "Hepatitis B virus infection: understanding its epidemiology, course, and diagnosis", Cleve Clin J Med, 75, pp.881~889 (2008)
- Negro F, "Impact of obesity, steatosis and insulin resistance on progression and response to therapy of hepatitis C", J Viral Hepat, 16, pp.681~688 (2009)
- Younossi ZM, "Metabolic syndrome, non-alcoholic fatty liver disease and hepatitis C virus: impact on disease progression and treatment response", Liver Int, 2(29 Suppl 2), pp.3~12 (2009)
- Rao GA, "Statin therapy improves sustained virologic response among diabetic patients with chronic hepatitis C", Gastroenterology, 140, pp.144~152 (2011)
- Demir M, "The prevalence of occult hepatitis B virus infection in type 2 diabetes mellitus patients", Eur J Gastroenterol Hepatol, 20, pp.668~673 (2008)
- Jan CF, "A population-based study investigating the association between metabolic syndrome and hepatitis B", C infection (Keelung Community-based Integrated Screening study No. 10), 2006, pp.30, 794~799
- Knodell RG, "Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis", Hepatology, 1, pp.431~435 (1981)
- Brunt EM, "Grading and staging the histopathological lesions of chronic hepatitis: the Knodell histology activity index and beyond", Hepatology, 31, pp.241~246 (2000)
- White DL, "Hepatitis C infection and risk of diabetes: a systematic review and meta-analysis", J Hepatol, 49, pp.831~844 (2008)
- Lao TT, "Maternal hepatitis B infection and gestational diabetes mellitus", J Hepatol, 47, pp.46~50 (2007)
- Athyros VG, "The prevalence of the metabolic syndrome in Greece: the MetS-Greece Multicentre Study", Diabetes Obes Metab, 7, pp.397~405 (2005)
- Thanopoulou A, "Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes", Eur J Clin Nutr, 60, pp.1376~1383 (2006)
- Ford ES, "Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey", JAMA, 287, pp.356~359 (2002)
- Siagris D, "Serum lipid pattern in chronic hepatitis C: histological and virological correlations", J Viral Hepat, 13, pp.56~61 (2006)
- Sanyal AJ, "Nonalcoholic fatty liver disease in patients with hepatitis C is associated with features of the metabolic syndrome", Am J Gastroenterol, 98, pp.2064~2071 (2003)
