Fibrogenic impact of high serum glucose in chronic hepatitis C.
OBJECTIVE
There is considerable variability in the rate of fibrosis progression in patients with chronic hepatitis C, most of which is related to factors so far unknown. We tested the hypothesis that high serum glucose and overweight might contribute to this variability.


METHODS
Seven hundred and ten patients with chronic hepatitis C with a known duration of infection and no hepatitis B virus or human immunodeficiency virus coinfection were studied. Significant fibrosis was defined as bridging fibrosis including cirrhosis. Variables were tested for their association with significant fibrosis.


RESULTS
In univariate analyses both serum glucose and body mass index were associated with fibrosis. In multivariate analyses, age at infection, duration of infection, serum glucose and daily alcohol intake but not body mass index were independently associated with significant fibrosis. Patients with high serum glucose had been contaminated at an older age and had features of the metabolic syndrome, including steatosis more frequently, as well as faster fibrosis progression rates. High serum glucose was associated with intermediate and advanced, but not with early, fibrosis stages. A high serum glucose was associated with a higher relative risk for significant fibrosis than overweight.


CONCLUSIONS
High serum glucose, is an independent co-factor of fibrosis in chronic hepatitis C with a higher pro-fibrogenic impact than overweight.
Ratziu
Vlad
V
Service d'Hépatogastroentérologie, Hôpital Pitié Salpétrière, 47-83 Bd de l'Hôpital, Paris 75013, France. vratziu@teaser.fr
Munteanu
Mona
M
Charlotte
Fréderic
F
Bonyhay
Luminita
L
Poynard
Thierry
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D005234:Fatty Liver / Q000097:blood / Q000150:complications* / Q000473:pathology; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000473:pathology; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications* / Q000473:pathology; D008103:Liver Cirrhosis / Q000097:blood / Q000150:complications* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000097:blood / Q000150:complications / Q000473:pathology
D001786:Blood Glucose