title: Association of visceral obesity with high viral load and histological findings in elderly patients with genotype 1 chronic hepatitis C.
abstract: OBJECTIVE
  Genotype 1 chronic hepatitis C (G1CHC) is generally accompanied by metabolic disturbances related to visceral obesity, such as insulin resistance, steatosis, or dyslipidemia. Because these abnormalities negatively influence the clinical course of G1CHC, we sought to clarify the effect of visceral obesity on the pathophysiology of G1CHC.
  
  
  METHODS
  We evaluated 180G1CHC patients for the presence of visceral obesity on the basis of computed tomography findings. Multivariate analysis was performed to estimate the relationship between visceral obesity and demographic, viral, and biochemical characteristics of patients. The associations of visceral obesity with histological findings and serum adipokine levels were also analyzed.
  
  
  RESULTS
  Multiple logistic regression analysis revealed that visceral obesity was independently associated with metabolic syndrome, platelet count, high-density lipoprotein level, and serum viral load in elderly patients (≥65 years). Multiple linear regression analysis confirmed the association between visceral obesity and high viral load. However, visceral obesity was not correlated with viral load in non-elderly patients (<65 years). Histological data (160 patients) demonstrated the significant association between visceral obesity and steatosis. Furthermore, patients with visceral obesity showed increase in the severity of fibrosis with advancing age. However, age-associated fibrosis progression was not evident in patients without visceral obesity. The serum adiponectin level was significantly low in patients with visceral obesity, whereas those of leptin, tumor necrosis factor-α, and interleukin-6 were not affected significantly.
  
  
  CONCLUSIONS
  Visceral obesity was associated with high viral load and histological damage in elderly patients with reduced adiponectin levels.
authors.affiliation: Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Tsuzura
authors.forename: Takuya
authors.initials: T
authors.lastname: Genda
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Sato
authors.forename: Katsuharu
authors.initials: K
authors.lastname: Hirano
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kanemitsu
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Narita
authors.forename: Tetsu
authors.initials: T
authors.lastname: Kikuchi
authors.forename: Katsuyori
authors.initials: K
authors.lastname: Iijima
authors.forename: Ryo
authors.initials: R
authors.lastname: Wada
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ichida
mesh_terms: D054392:Adipokines / Q000097:blood; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D056128:Obesity, Abdominal / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D015995:Prevalence; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D019562:Viral Load / Q000502:physiology*
chemical_list: D054392:Adipokines