title: Association of insulin resistance, viral load, and adipokine levels with liver histology in patients with chronic hepatitis C:  an observational, multicenter study in Turkey.
abstract: OBJECTIVE
  To evaluate the association of insulin resistance (IR), viral load, and adipokine levels with liver histology in patients with chronic hepatitis C (CHC).
  
  
  METHODS
  In this noninterventional, multicenter study carried out at 11 infectious diseases clinics in Turkey, 103 CHC patients [mean (SD) age: 50.2 (11.0) years, 60 (58.3%) women] planned to be treated by ribavirin and peginterferon-α2a were included. Data on hepatic fibrosis and steatosis, IR, viral load, and hepatitis C virus-RNA genotyping, adipokine, and cytokine levels were collected.
  
  
  RESULTS
  The mean (SD) Knodell score was 8.1 (3.6); grade I steatosis was evident in 46 (44.7%) patients and IR was identified in 56 (54.9%). There was a significant positive correlation of the homeostasis model assessment-IR index with Knodell fibrosis (r=0.235; P=0.027) and hepatic steatosis (r=0.435; P<0.001). There was a significant positive correlation of leptin levels with Knodell fibrosis (r=0.265; P=0.013) and hepatic activity index (r=0.218; P=0.041). Hepatic steatosis was correlated negatively with adiponectin (r=-0.320; P=0.001) and positively with leptin (r=-0.368; P<0.001) levels. Logistic regression analysis showed that increase in age [odds ratio (OR), 1.056; 95% confidence interval (CI), 1.005-1.110; P=0.030] was the only significant predictor of hepatic fibrosis (OR, 1.056; 95% CI, 1.005-1.110; P=0.030), whereas increase in age (OR, 1.066; 95% CI, 1.006-1.130; P=0.030), the presence of IR (OR, 5.621; 95% CI, 1.547-20.425; P=0.009), and decrease in adiponectin levels (OR, 0.808; 95% CI, 0.682-0.957; P=0.013) were the significant predictors of hepatic steatosis.
  
  
  CONCLUSIONS
  Our findings indicate a significant relationship of hepatic fibrosis and hepatic steatosis with IR and leptin levels, but not with the viral load in Turkish patients with CHC.
authors.affiliation: Department of Infectious Diseases and Clinical Microbiology, University School of Medicine, Adana, Turkey. hszaksu@gmail.com
authors.forename: Hasan S Zeki
authors.initials: HS
authors.lastname: Aksu
authors.forename: Behice
authors.initials: B
authors.lastname: Kurtaran
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Onlen
authors.forename: Mustafa
authors.initials: M
authors.lastname: Namiduru
authors.forename: Ahmet C
authors.initials: AC
authors.lastname: Inkaya
authors.forename: Ozlem
authors.initials: O
authors.lastname: Kandemir
authors.forename: Figen
authors.initials: F
authors.lastname: Doran
authors.forename: Omer
authors.initials: O
authors.lastname: Evirgen
authors.forename: Yesim
authors.initials: Y
authors.lastname: Alpay
authors.forename: Suda K
authors.initials: SK
authors.lastname: Tekin
authors.forename: Yesim
authors.initials: Y
authors.lastname: Kurekci
authors.forename: Berrin
authors.initials: B
authors.lastname: Unlu
authors.forename: Durdane
authors.initials: D
authors.lastname: Midikli
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Taşova
authors.forename: Fatih
authors.initials: F
authors.lastname: Ozdener
authors.forename: Seda
authors.initials: S
authors.lastname: Erdogan
mesh_terms: D054392:Adipokines / Q000097:blood*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007333:Insulin Resistance; D008099:Liver / Q000473:pathology* / Q000821:virology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000097:blood; D014421:Turkey / Q000453:epidemiology; D019562:Viral Load
chemical_list: D054392:Adipokines; D015415:Biomarkers; D012367:RNA, Viral