title: Prevalence and predictors of hepatic steatosis in adults with newly diagnosed chronic liver disease due to hepatitis C.
abstract: Obesity appears to be a risk factor for hepatic steatosis, which has been implicated in the development of hepatic fibrosis in patients with hepatitis C virus infection. We conducted the current study to examine whether obesity is associated with hepatic steatosis among patients with chronic hepatitis C identified from a population-based cohort. Study participants were persons with chronic hepatitis C who had had a liver biopsy, identified from a population-based study of persons with newly identified chronic liver disease conducted in gastroenterology practices. Data were collected through patient interviews, medical record abstraction, and review of previously performed liver biopsies. The outcome variable of interest was significant steatosis, defined as steatosis grade > or =2 determined from liver biopsy samples. Univariate and multivariate analyses were performed using logistic regression techniques. The analysis included 450 patients with chronic hepatitis C with available liver biopsy slides. Overall, only 15.8% of subjects had significant hepatic steatosis (grade > or =2), while 35.9% of obese subjects had significant steatosis. In multivariate analysis, significant fibrosis (defined as > or = grade 2) (odds ratio [OR], 3.43; 95% confidence interval [CI], 1.59-7.37), obesity (OR, 3.32; 95% CI, 1.84-5.98), genotype 3 (OR, 2.5; 95% CI, 1.09-5.75), and the presence of multiple metabolic comorbidities (OR, 1.91; 95% CI, 0.88-4.11) were independently associated with steatosis. In this unique United States cohort of patients with newly diagnosed chronic liver disease due to hepatitis C, obesity was independently associated with hepatic steatosis. The results of this study provide additional evidence that obesity worsens liver damage in patients with chronic hepatitis C, and suggest a role for weight loss as a treatment modality in these patients.
authors.affiliation: From Oregon Health & Science University (AVH, CC, AZ), Portland, Oregon; Yale University School of Medicine (ANS, NS, MR), New Haven, Connecticut; Kaiser Permanente Division of Research (MMM), Oakland, California; Oregon Public Health Division (AT, GVN), Portland, Oregon; University of California, San Francisco (NT), San Francisco, California; The Kaiser Permanente Medical Group (GR), Oakland, California; Centers for Disease Control and Prevention (BB, SB), Atlanta, Georgia.
authors.forename: Amanda V
authors.initials: AV
authors.lastname: Hayman
authors.forename: Andre N
authors.initials: AN
authors.lastname: Sofair
authors.forename: M Michele
authors.initials: MM
authors.lastname: Manos
authors.forename: Ann
authors.initials: A
authors.lastname: Thomas
authors.forename: Norah
authors.initials: N
authors.lastname: Terrault
authors.forename: Grace Van
authors.initials: GV
authors.lastname: Ness
authors.forename: Nicole
authors.initials: N
authors.lastname: Stabach
authors.forename: Marie
authors.initials: M
authors.lastname: Robert
authors.forename: Gregory
authors.initials: G
authors.lastname: Rumore
authors.forename: Christopher
authors.initials: C
authors.lastname: Corless
authors.forename: Beth
authors.initials: B
authors.lastname: Bell
authors.forename: Stephanie
authors.initials: S
authors.lastname: Bialek
authors.forename: Atif
authors.initials: A
authors.lastname: Zaman
mesh_terms: D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005355:Fibrosis / Q000150:complications; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D007249:Inflammation / Q000150:complications; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult