title: Impact of serum levels of interleukin-6 and adiponectin on all-cause, liver-related, and liver-unrelated mortality in chronic hepatitis C patients.
abstract: OBJECTIVE
  Various inflammatory cytokines and adipokines have been implicated in hepatitis C virus (HCV)-mediated liver disease, and interleukin-6 (IL-6) and adiponectin may play key roles. In addition, these factors may be associated with chronic hepatitis C (CHC)-induced extrahepatic manifestations. However, little data are available on the role of these factors on future outcomes of CHC patients. This study aims to evaluate the impact of serum levels of IL-6 and adiponectin on all-cause mortality, liver-related mortality, and liver-unrelated mortality.
  
  
  METHODS
  A long-term follow-up study was conducted, consisting of 325 CHC patients, for which we previously reported positive associations between these factors (Serum levels of IL-6 and adiponectin) and hepatocellular carcinoma (HCC) development.
  
  
  RESULTS
  During the follow-up period (mean, 13.0 year), there were 92 events consisting of 91 deaths (liver related, 72; liver unrelated, 19) and 1 liver transplantation due to liver failure. High IL-6 and adiponectin levels, defined as being higher than each median value at baseline, were associated with significantly higher incidences of not only HCC development but also all-cause mortality. Interestingly, high IL-6 was strongly associated with only liver-related mortality, whereas high-serum adiponectin was associated with not only liver-related, but also liver-unrelated mortality. Multivariate analysis identified high IL-6 as an independent risk factor for liver-related mortality and high adiponectin as an independent risk factor for liver-unrelated mortality.
  
  
  CONCLUSIONS
  High serum levels of IL-6 and adiponectin were associated with higher all-cause and liver-related mortality in CHC patients. In addition, high adiponectin was associated with liver-unrelated mortality. The measurement of these factors may provide information useful for predicting future outcomes in CHC patients.
authors.affiliation: Department of Gastroenterology, The University of Tokyo, Tokyo, Japan.
authors.forename: Hayato
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Naoto
authors.initials: N
authors.lastname: Fujiwara
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tateishi
authors.forename: Toru
authors.initials: T
authors.lastname: Arano
authors.forename: Ryo
authors.initials: R
authors.lastname: Nakagomi
authors.forename: Mayuko
authors.initials: M
authors.lastname: Kondo
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Minami
authors.forename: Masaya
authors.initials: M
authors.lastname: Sato
authors.forename: Koji
authors.initials: K
authors.lastname: Uchino
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Enooku
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Asaoka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kondo
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Yoshida
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002243:Carbolines; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008107:Liver Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors
chemical_list: D052242:Adiponectin; D015415:Biomarkers; D002243:Carbolines; C508600:IL6 protein, human; D015850:Interleukin-6; C025079:diazoline
keywords: adipokine; hepatitis C; inflammatory cytokine; mortality