title: Metabolic syndrome is associated with severe fibrosis in chronic viral hepatitis and non-alcoholic steatohepatitis.
abstract: BACKGROUND
  The prevalence of metabolic syndrome and its possible impact on the severity of liver histological lesions have not been studied prospectively in chronic liver diseases.
  
  
  OBJECTIVE
  To investigate the prevalence of metabolic syndrome in patients with chronic viral hepatitis or non-alcoholic steatohepatitis, and to determine its associations with histological severity.
  
  
  METHODS
  We prospectively included 317 patients (hepatitis B e antigen-negative chronic hepatitis B: 95, chronic hepatitis C: 176, non-alcoholic steatohepatitis: 46) with liver biopsy. Metabolic syndrome was defined using the Adult Treatment Panel III criteria. Histological lesions were evaluated according to Ishak's or Brunt's classification.
  
  
  RESULTS
  Metabolic syndrome was present in 10.4% of patients being significantly more prevalent in non-alcoholic steatohepatitis than in chronic viral hepatitis (41.3% vs. 5.1%, P < 0.001). In chronic viral hepatitis, cirrhosis (stages 5-6) was independently associated with increasing age, higher aspartate aminotransferase and gamma-glutamyl-transpeptidase levels, severe necroinflammation and metabolic syndrome (P = 0.016). In non-alcoholic steatohepatitis, severe fibrosis (stages 3-4) was independently associated with severe necroinflammation and metabolic syndrome (P = 0.033). Presence of metabolic syndrome was not associated with presence or severity of steatosis both in chronic viral hepatitis and in non-alcoholic steatohepatitis.
  
  
  CONCLUSIONS
  Metabolic syndrome is more prevalent in non-alcoholic steatohepatitis than in chronic viral hepatitis; it is associated independently with more severe fibrosis but not with the severity of steatosis, both in chronic viral hepatitis and in non-alcoholic steatohepatitis.
authors.affiliation: 2nd Department of Internal Medicine, Athens University Medical School, Hippokration General Hospital, Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Tsochatzis
authors.forename: G V
authors.initials: GV
authors.lastname: Papatheodoridis
authors.forename: E K
authors.initials: EK
authors.lastname: Manesis
authors.forename: G
authors.initials: G
authors.lastname: Kafiri
authors.forename: D G
authors.initials: DG
authors.lastname: Tiniakos
authors.forename: A J
authors.initials: AJ
authors.lastname: Archimandritis
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D005234:Fatty Liver / Q000150:complications*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase