Glucose intolerance and hypoadiponectinemia are already present in lean patients with chronic hepatitis C infected with genotype non-3 viruses.
OBJECTIVE
Steatosis and metabolic abnormalities seem to be frequent and deleterious in chronic hepatitis C. Changes in glucose homeostasis and in adiponectin levels, an adipokine with anti-inflammatory and insulin-sensitive properties, were evaluated in patients with chronic hepatitis C according to steatosis, liver fibrosis and body mass index.


METHODS
Seventy-three patients with chronic hepatitis C (40 men, 33 women) infected with genotypes non-3 and 22 healthy controls (11 men and 11 women) were included in the study and all had a biochemical evaluation, including metabolic parameters, adiponectin measurement, and a liver biopsy. Insulin sensitivity was assessed with the HOMA 1-IR insulin resistance model.


RESULTS
Steatosis was found in 65.7% of the patients and significant fibrosis (METAVIR F2-F4) was present in 28.7%. The presence of steatosis could only be predicted by fibrosis, whereas significant fibrosis could be predicted by steatosis and age. Adiponectin levels were significantly decreased (-32%) with the severity of the steatosis. Although overweight chronic hepatitis C patients (body mass index>or=25 kg/m2) had insulin resistance and hypoadiponectinemia, lean chronic hepatitis C patients (body mass index<25 kg/m2) had already significantly higher glycemia and lower adiponectin levels than in controls.


CONCLUSIONS
This study confirms the high incidence of steatosis in patients infected by hepatitis C virus genotypes non-3, well linked to the development of fibrosis and metabolic abnormalities. Importantly, the present findings put emphasis on the early development of these metabolic abnormalities as they were already found in lean patients with chronic hepatitis C. The direct implication of hepatitis C virus is thus further stressed in the development of steatosis and insulin resistance, with or without involvement of host factors.
Anty
Rodolphe
R
Centre Hospitalier de Nice, Pôle digestif, Nice, France. rodolphe.anty@laposte.net
Gelsi
Eve
E
Giudicelli
Jean
J
Mariné-Barjoan
Eugenia
E
Gual
Philippe
P
Benzaken
Sylvia
S
Saint-Paul
Marie-Christine
MC
Sadoul
Jean Louis
JL
Huet
Pierre Michel
PM
Tran
Albert
A
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D015992:Body Mass Index; D005234:Fatty Liver / Q000821:virology*; D005260:Female; D005838:Genotype; D018149:Glucose Intolerance / Q000821:virology*; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000821:virology; D006801:Humans; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000097:blood / Q000821:virology; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013851:Thinness / Q000097:blood*
D052242:Adiponectin