Differences and similarities in early atherosclerosis between patients with non-alcoholic steatohepatitis and chronic hepatitis B and C.
OBJECTIVE
To compare carotid intima-media thickness (IMT) - an index of early atherosclerosis - among patients with non-alcoholic steatohepatitis (NASH), patients with chronic hepatitis B (HBV) or C (HCV) and control subjects.


METHODS
We studied 60 consecutive patients with biopsy-proven NASH, 60 patients with HCV, 35 patients with HBV, and 60 healthy controls who were comparable for age and sex. Common carotid IMT was measured with ultrasonography in all participants by a single operator blinded to subjects' characteristics.


RESULTS
Carotid IMT measurements were markedly different among the groups; the lowest values were in controls, intermediate in patients with HBV or HCV, and highest in those with NASH (0.84+/-0.1 vs. 0.97+/-0.1 vs. 1.09+/-0.2 vs. 1.23+/-0.2mm, respectively; p<0.001). The marked differences in carotid IMT that were observed among the groups were little affected by adjustment for age, sex, body mass index, smoking, LDL cholesterol, insulin resistance (by homeostasis model assessment) and components of the Adult Treatment Panel III-defined metabolic syndrome. Concordantly, in logistic regression analysis, NASH, HBV and HCV predicted carotid IMT independent of potential confounders.


CONCLUSIONS
These data suggest that NASH, HCV and HBV are strongly associated with early atherosclerosis independent of classical risk factors, insulin resistance and metabolic syndrome components.
Targher
Giovanni
G
Division of Internal Medicine and Diabetes Unit, Sacro Cuore-don Calabria Hospital, Via Sempreboni 5, 37024 Negrar (VR), Italy. targher@sacrocuore.it
Bertolini
Lorenzo
L
Padovani
Roberto
R
Rodella
Stefano
S
Arcaro
Guido
G
Day
Christopher
C
D000328:Adult; D050197:Atherosclerosis / Q000150:complications* / Q000175:diagnosis*; D001706:Biopsy; D002339:Carotid Arteries / Q000473:pathology; D005234:Fatty Liver / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis*; D006526:Hepatitis C / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology