title: Hyperuricaemia: another metabolic feature affecting the severity of chronic hepatitis because of HCV infection.
abstract: BACKGROUND
  Several works observed a link between uric acid serum levels and clinical and histological features of nonalcoholic fatty liver disease. An association between chronic hepatitis C (CHC) and uric acid levels has been poorly investigated.
  
  
  OBJECTIVE
  To assess the potential association between uric acid serum levels and both histological features of liver damage and sustained virological response (SVR) in a homogeneous cohort of CHC patients.
  
  
  METHODS
  Consecutive biopsy-proven CHC patients were included. Hyperuricaemia was diagnosed with uric acid serum levels >7 mg/dl in men, and >6 mg/dl in women. Patients underwent therapy with pegylated interferon plus ribavirin.
  
  
  RESULTS
  Hyperuricaemia, observed in 7.5% of patients, was associated with low density lipoprotein cholesterol (OR 1.015, 95% CI 1.004-1.026, P = 0.008), arterial hypertension (OR 3.024, 95% CI 1.290-7.088, P = 0.01), estimated glomerular filtration rate (OR 0.942, 95% CI 0.919-0.965, P < 0.001) and severity of steatosis (OR 3.176, 95% CI 1.828-5.517, P < 0.001) by multivariate logistic regression analysis. The following features were independently linked to the severity of liver steatosis (<5% vs. ≥5% to <30% vs. ≥30%) using ordinal regression analysis: age (OR 1.027, 95% CI 1.011-1.044, P = 0.01), body mass index (OR 1.088, 95% CI 1.039-1.138, P < 0.001), triglycerides (OR 1.005, 95% CI 1.001-1.009, P = 0.02), homeostasis model assessment (OR 1.095, 95% CI 1.014-1.184, P = 0.02), hyperuricaemia (OR 2.751, 95% CI 1.423-5.322, P = 0.003), hepatitis C virus genotype 3 (OR 4.567, 95% CI 1.515-13.763, P = 0.007) and severe necroinflammatory activity (OR 1.584, 95% CI 1.067-2.349, P = 0.02). No independent association was found among uric acid levels and necroinflammatory activity, fibrosis and SVR.
  
  
  CONCLUSIONS
  In CHC patients, hyperuricaemia was independently associated with severity of steatosis, representing, in this setting, via steatosis induction, an indirect factor affecting both liver damage and poor response to therapy, and thus a novel potential therapeutic target in CHC management.
authors: Cattedra di Gastroenterologia, DiBiMIS, University of Palermo, Palermo, Italy. petsa@inwind.it
authors: Salvatore
authors: S
authors: Petta
authors: Fabio S
authors: FS
authors: Macaluso
authors: Calogero
authors: C
authors: Cammà
authors: Vito D
authors: VD
authors: Marco
authors: Daniela
authors: D
authors: Cabibi
authors: Antonio
authors: A
authors: Craxì
mesh_terms: D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D005234:Fatty Liver / Q000097:blood / Q000150:complications / Q000175:diagnosis; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D033461:Hyperuricemia / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014527:Uric Acid / Q000097:blood*
chemical_list: D015415:Biomarkers; D014527:Uric Acid