Interplay between oxidative stress and hepatic steatosis in the progression of chronic hepatitis C.
OBJECTIVE
The contribution of oxidative stress to the pathogenesis of chronic hepatitis C (CHC) is still poorly elucidated. This study investigated the relationship between oxidative stress, insulin resistance, steatosis and fibrosis in CHC.


METHODS
IgG against malondialdehyde-albumin adducts and HOMA-IR were measured as markers of oxidative stress and insulin resistance, respectively, in 107 consecutive CHC patients.


RESULTS
Oxidative stress was present in 61% of the patients, irrespective of age, gender, viral load, BMI, aminotransferase level, histology activity index (HAI) and HCV genotype. Insulin resistance and steatosis were evident in 80% and 70% of the patients, respectively. In the patients infected by HCV genotype non-3, but not in those with genotype 3 infection HOMA-IR (p<0.03), steatosis (p=0.02) and fibrosis (p<0.05) were higher in the subjects with oxidative stress than in those without. Multiple regression analysis revealed that, HOMA-IR (p<0.01), fibrosis (p<0.01) and oxidative stress (p<0.05) were independently associated with steatosis, whereas steatosis was independently associated with oxidative stress (p<0.03) and HOMA-IR (p<0.02). Steatosis (p<0.02) and HAI (p=0.007) were also independent predictors of fibrosis.


CONCLUSIONS
In patients infected by HCV genotype non-3, oxidative stress and insulin resistance contribute to steatosis, which in turn exacerbates both insulin resistance and oxidative stress and accelerates the progression of fibrosis.
Vidali
Matteo
M
Department of Medical Sciences, University Amedeo Avogadro of East Piedmont, Novara, Italy.
Tripodi
Marie-Francoise
MF
Ivaldi
Alesandra
A
Zampino
Rosa
R
Occhino
Giuseppa
G
Restivo
Luciano
L
Sutti
Salvatore
S
Marrone
Aldo
A
Ruggiero
Giuseppe
G
Albano
Emanuele
E
Adinolfi
Luigi E
LE
D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D018450:Disease Progression; D005234:Fatty Liver / Q000503:physiopathology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008103:Liver Cirrhosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018384:Oxidative Stress / Q000502:physiology*; D011237:Predictive Value of Tests
D007074:Immunoglobulin G