title: Hepatitis C virus infection causes hypolipidemia regardless of hepatic damage or nutritional state: An epidemiological survey of a large Japanese cohort.
abstract: OBJECTIVE
  Infection with hepatitis C virus (HCV) is the leading cause of liver cirrhosis that develops into hepatocellular carcinoma. Previous studies have shown in vitro that lipids within hepatocytes are crucially important for a series of HCV infection-proliferation-release processes. On the other hand, in the patients with HCV, the serum total cholesterol (Total-C) and low-density lipoprotein cholesterol (LDL-C) levels have been reported to be lower. We conducted an epidemiological survey of a large cohort and investigated whether the lower serum lipid levels were caused by a direct or the secondary effects of HCV infection (i.e. hepatic damage or nutritional disorder).
  
  
  METHODS
  Among 146 857 participants (male, 34%; female, 66%) undergoing public health examinations between 2002 and 2007 in Ibaraki Prefecture, Japan, the HCV positive rates determined by HCV antibody/antigen and/or RNA tests were 1.37% and 0.67% in males and females, respectively.
  
  
  RESULTS
  In addition to Total-C and LDL-C, serum high-density lipoprotein cholesterol and triglyceride concentrations were also significantly lower in the HCV positive subjects compared with the negative subjects, regardless of sex, age or nutritional state evaluated by body mass index. Multivariate analysis showed that HCV infection was the strongest among the factors to be significantly associated with the lower level of these lipids. Particularly, the hypolipidemia was also confirmed in the HCV positive subjects with normal aminotransferase levels (alanine aminotransferase ≤30 and aspartate aminotransferase ≤30).
  
  
  CONCLUSIONS
  This epidemiological survey in a large Japanese cohort suggests that the HCV infection itself might directly cause hypolipidemia, irrespective of host factors including age, hepatic damage and nutritional state.
authors.affiliation: Department of Development for Community Medicine, Tokyo Medical University Center for Collaborative Research Department of Internal Medicine, Division of Gastroenterology and Hepatology, Tokyo Medical University Ibaraki Medical Center Ibaraki Prefectural Institute of Public Health, Mito Ibaraki Prefectural Central Hospital, Kasama, Japan.
authors.forename: Teruo
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Akira
authors.initials: A
authors.lastname: Honda
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ikegami
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Saitoh
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hirayama
authors.forename: Takashi
authors.initials: T
authors.lastname: Hara
authors.forename: Mikio
authors.initials: M
authors.lastname: Doy
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsuzaki