title: Overweight and obesity, hepatic steatosis, and progression of chronic hepatitis C: a retrospective study on a large cohort of patients in the United States.
abstract: BACKGROUND
  Hepatic steatosis has been associated with chronic hepatitis C (CHC), but its prevalence, risk factors, and clinical significance remain to be determined.
  
  
  OBJECTIVE
  The present study determined the frequency of, and risk factors for hepatic steatosis and its association with activity and progression of CHC in a large cohort of U.S. patients.
  
  
  METHODS
  This is a retrospective study that utilized systematic chart review and statistical analyzes to investigate 324 U.S. patients with CHC from a university medical center and a regional VA medical center.
  
  
  RESULTS
  The frequency of hepatic steatosis was 66.0%. We demonstrated that not only being obese, but also overweight (i.e. body mass index > or =25 kg/m(2)) was independently associated with hepatic steatosis. In our cohort of patients with CHC, hepatic steatosis, especially grade II/III steatosis, was significantly associated with elevated aspartate aminotransferase at entry, persistently elevated alanine aminotransferase, and stage III/IV fibrosis. Grade II/III steatosis, was significantly associated with a higher histology activity index as well. Multivariate analysis indicated that steatosis, especially grade II/III steatosis, was independently associated with stage III/IV fibrosis.
  
  
  CONCLUSIONS
  Being overweight/obese serves as an independent risk factor for hepatic steatosis in U.S. patients with CHC. Steatosis accelerates activity and progression of CHC, and is independently associated with stage III/IV hepatic fibrosis in these patients.
authors.affiliation: Division of Gastroenterology/Hepatology, University of California-Irvine, Orange, CA 92868, USA. kqhu@uci.edu
authors.forename: Ke-Qin
authors.initials: KQ
authors.lastname: Hu
authors.forename: Namgyal L
authors.initials: NL
authors.lastname: Kyulo
authors.forename: Eric
authors.initials: E
authors.lastname: Esrailian
authors.forename: Kevin
authors.initials: K
authors.lastname: Thompson
authors.forename: Resa
authors.initials: R
authors.lastname: Chase
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Hillebrand
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Runyon
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D015992:Body Mass Index; D015331:Cohort Studies; D003710:Demography; D018450:Disease Progression; D005234:Fatty Liver / Q000201:enzymology / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications* / Q000473:pathology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase