title: Predictive value of the fibrosis scores in patients with chronic hepatitis C associated with liver fibrosis and metabolic syndrome.
abstract: OBJECTIVE
  We evaluated patients with chronic hepatitis C (CHC) and compared the clinical and pathological features of steatosis and metabolic syndrome to identify the risk factors for CHC with severe fibrosis.
  
  
  METHODS
  One hundred seventy-one patients with biopsy-confirmed CHC were included in the study: 90 males and 81 females, age 56.2 ± 12.8 years; 46 with obesity (BMI≥25 kg/m(2)); 51 with hypertension; 36 with type 2 diabetes mellitus; and 20 with hypertriglyceridemia.
  
  
  RESULTS
  Steatosis was detected in 79 patients (46%); 92 patients (54%) showed no steatosis. Seventy-four patients (43%) showed mild fibrosis and 97 patients (56%) showed severe fibrosis. The variables that were significantly associated with steatosis were obesity [odds ratio 2.160 (1.010-4.727), p=0.046] and type 2 diabetes [odds ratio 3.667 (1.559-8.430), p=0.027]. The variables that were significantly associated with severe fibrosis were older age [odds ratio 2.675 (1.309-5.464), p=0.007], obesity [odds ratio 2.156 (1.006-4.619), p=0.048] and type 2 diabetes [odds ratio 8.739 (2.845-26.846), p=0.0002]. Nagasaki (N) score (the total number of specific risk factors, namely an older age, obesity, and type 2 diabetes) was higher in the severe fibrosis group than in the mild fibrosis group (mild fibrosis: severe fibrosis=1.48 ± 1.14 vs.2.66 ± 94, p<0.001).
  
  
  CONCLUSIONS
  Metabolic syndrome factors, including obesity and diabetes, play a critical role in the pathogenesis of fibrosis in CHC. The N score was therefore found to be a significant predictor of severe fibrosis in CHC.
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Japan. miyaaki-hi@umin.ac.jp
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Miyaaki
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Naota
authors.initials: N
authors.lastname: Taura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miuma
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Shibata
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.forename: Fuminao
authors.initials: F
authors.lastname: Takeshima
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001706:Biopsy; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D005234:Fatty Liver / Q000453:epidemiology / Q000473:pathology; D005260:Female; D019698:Hepatitis C, Chronic / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000473:pathology*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index