title: Cryoglobulinemia is associated with steatosis and fibrosis in chronic hepatitis C.
abstract: The relationship between cryoglobulin and severity of liver lesions is debated. No study has focused on the relationship between cryoglobulin, liver steatosis, and fibrosis. The aim of this study was to determine the relationship between cryoglobulins and liver lesions (necroinflammation, fibrosis, and steatosis) in patients with hepatitis C virus (HCV) infection. Four hundred and thirty-seven consecutive patients with untreated chronic hepatitis C who had been admitted for liver biopsy were included in the study. Risk factors for fibrosis and steatosis were assessed. The mean age was 50.9 +/- 13.8 years, and 49% were male. Cryoglobulin was present in 286 patients, 103 of whom had vasculitis. One hundred and eighty-six patients (43%) had steatosis greater than 10%, and 110 (25%) had advanced fibrosis (Metavir score F3-F4). On multivariate analysis, cryoglobulin increased by nearly threefold the risk of having advanced fibrosis and steatosis greater than 10%. Steatosis greater than 10% was associated with a higher body mass index (P < .001), HCV genotype 3 (P < .001), cryoglobulin (P = .002), and advanced liver fibrosis (P = .009). Advanced fibrosis (F3-F4) was associated with a higher level of gamma-glutamyltransferase (P = .04), cryoglobulin (P < .001), a high grade of necroinflammation (Metavir score A2-A3) (P < .001), and steatosis higher than 10% (P = .04). In conclusion, our study shows an independent association between cryoglobulin and steatosis as well as advanced fibrosis.
authors.affiliation: Service de Médecine Interne and CNRS UMR 7087, Hôpital Pitié-Salpétrière, Paris, France.
authors.forename: David
authors.initials: D
authors.lastname: Saadoun
authors.forename: Tarik
authors.initials: T
authors.lastname: Asselah
authors.forename: Mathieu
authors.initials: M
authors.lastname: Resche-Rigon
authors.forename: Frédéric
authors.initials: F
authors.lastname: Charlotte
authors.forename: Pierre
authors.initials: P
authors.lastname: Bedossa
authors.forename: Dominique
authors.initials: D
authors.lastname: Valla
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Piette
authors.forename: Patrick
authors.initials: P
authors.lastname: Marcellin
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
mesh_terms: D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D015415:Biomarkers / Q000378:metabolism; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D003449:Cryoglobulinemia / Q000175:diagnosis / Q000453:epidemiology*; D003450:Cryoglobulins / Q000378:metabolism; D018450:Disease Progression; D005234:Fatty Liver / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution
chemical_list: D015415:Biomarkers; D003450:Cryoglobulins