title: Hepatic steatosis and insulin resistance are associated with serum imbalance of adiponectin/tumour necrosis factor-alpha in chronic hepatitis C patients.
abstract: BACKGROUND
  Steatosis and insulin resistance (IR) have a pathogenic role in chronic hepatitis C (HCV). Adipocytokines balance modulates hepatic lipid content and IR.
  
  
  OBJECTIVE
  To evaluate serum adipocytokines and relationship with virological, histological and metabolic parameters in chronic HCV.
  
  
  METHODS
  Adiponectin and tumour necrosis factor-alpha (TNF-alpha) levels, HCV genotypes, HCV-RNA, IR (HOMA-IR), body mass index and liver steatosis and fibrosis were assessed in 161 non-diabetic chronic HCV patients.
  
  
  RESULTS
  Chronic HCV patients with steatosis showed lower serum adiponectin levels and higher levels of TNF-alpha, HOMA, alanine aminotransferase, gamma-glutamiltransferase and Histological Activity Index (HAI) and fibrosis scores. Low adiponectin levels were independently associated with grades of steatosis and HOMA-IR. Higher tumour necrosis factor-alpha levels were observed in patients with low adiponectin levels. The extension of steatosis was inversely correlated with adiponectin levels. A correlation between grade of steatosis with HOMA-IR and fibrosis was observed. HCV genotype 3-infected patients showed lower adiponectin levels than those with other genotypes. An independent predictor of low adiponectin levels in genotype 3 infection was the extension of steatosis. Liver fibrosis score was associated with steatosis, HAI and age.
  
  
  CONCLUSIONS
  Chronic HCV patients with steatosis showed a serum adiponectin/TNF-alpha imbalance that is associated with IR. Reduced adiponectin levels may be involved in the pathogenesis of steatosis, which in turn accelerates progression of fibrosis in chronic HCV.
authors.affiliation: Internal Medicine & Hepatology, Second University of Naples Medical School, Napoli, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Durante-Mangoni
authors.forename: R
authors.initials: R
authors.lastname: Zampino
authors.forename: A
authors.initials: A
authors.lastname: Marrone
authors.forename: M-F
authors.initials: MF
authors.lastname: Tripodi
authors.forename: L
authors.initials: L
authors.lastname: Rinaldi
authors.forename: L
authors.initials: L
authors.lastname: Restivo
authors.forename: M
authors.initials: M
authors.lastname: Cioffi
authors.forename: G
authors.initials: G
authors.lastname: Ruggiero
authors.forename: L E
authors.initials: LE
authors.lastname: Adinolfi
mesh_terms: D052242:Adiponectin / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D005234:Fatty Liver / Q000097:blood / Q000209:etiology*; D005260:Female; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D052242:Adiponectin; D001786:Blood Glucose; D014409:Tumor Necrosis Factor-alpha