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Nonalcoholic fatty liver disease in patients with hepatitis C is associated with features of the metabolic syndrome.
Am J Gastroenterol 2003; 98(9):2064-71AJ

Abstract

OBJECTIVES

The objectives of this study were to determine the following: 1) whether chronic hepatitis C virus (HCV) infection was specifically associated with nonalcoholic fatty liver disease (NAFLD); 2) the factors associated with NAFLD in patients with HCV; and 3) the clinical and histological spectrum of NAFLD occurring together with HCV.

METHODS

A retrospective analysis of 3826 biopsies was performed to compare the prevalence of NAFLD in those with HCV versus that in other liver diseases, e.g., hepatitis B, primary biliary cirrhosis, and alpha(1)-antitrypsin deficiency. Patients with HCV and NAFLD were also compared with an age- and gender-matched control group with HCV and <5% hepatic steatosis.

RESULTS

The prevalence of NAFLD in patients with HCV was similar to that in hepatitis B, primary biliary cirrhosis, or alpha(1)-antitrypsin deficiency. The risk of having NAFLD in patients with HCV correlated with body weight (r = 0.7, p < 0.02). Compared with a control group with HCV alone (n = 75), patients with HCV and NAFLD (n = 69) were likely to be heavier (mean BMI 27 vs 30, p < 0.003), diabetic (eight vs 21, p < 0.005), hypertensive (14 vs 25, p < 0.05), and hypertriglyceridemic (15 vs 33, p < 0.05). The HCV viral load, genotype distribution, liver enzymes, liver functions, and ferritin levels were comparable across the study groups. Those with HCV and NAFLD were more likely to have advanced fibrosis (bridging fibrosis or cirrhosis) (26% vs 53%, p < 0.03). Weight, diabetes, and cytological ballooning were independent predictors of advanced fibrosis in those with HCV and NAFLD.

CONCLUSIONS

The presence of NAFLD in patients with HCV is strongly associated with features of the metabolic syndrome and is a risk factor for advanced fibrosis. Advanced fibrosis in such patients is related to weight, presence of diabetes, and presence and degree of cytological ballooning.

Authors+Show Affiliations

Department of Pathology, Virginia Commonwealth University Health System, Richmond, Virginia, USA.

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14499789

Citation

Sanyal, Arun J., et al. "Nonalcoholic Fatty Liver Disease in Patients With Hepatitis C Is Associated With Features of the Metabolic Syndrome." The American Journal of Gastroenterology, vol. 98, no. 9, 2003, pp. 2064-71.
Sanyal AJ, Contos MJ, Sterling RK, et al. Nonalcoholic fatty liver disease in patients with hepatitis C is associated with features of the metabolic syndrome. Am J Gastroenterol. 2003;98(9):2064-71.
Sanyal, A. J., Contos, M. J., Sterling, R. K., Luketic, V. A., Shiffman, M. L., Stravitz, R. T., & Mills, A. S. (2003). Nonalcoholic fatty liver disease in patients with hepatitis C is associated with features of the metabolic syndrome. The American Journal of Gastroenterology, 98(9), pp. 2064-71.
Sanyal AJ, et al. Nonalcoholic Fatty Liver Disease in Patients With Hepatitis C Is Associated With Features of the Metabolic Syndrome. Am J Gastroenterol. 2003;98(9):2064-71. PubMed PMID: 14499789.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nonalcoholic fatty liver disease in patients with hepatitis C is associated with features of the metabolic syndrome. AU - Sanyal,Arun J, AU - Contos,Melissa J, AU - Sterling,Richard K, AU - Luketic,Velimir A, AU - Shiffman,Mitchell L, AU - Stravitz,R Todd, AU - Mills,A Scott, PY - 2003/9/23/pubmed PY - 2003/11/7/medline PY - 2003/9/23/entrez SP - 2064 EP - 71 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 98 IS - 9 N2 - OBJECTIVES: The objectives of this study were to determine the following: 1) whether chronic hepatitis C virus (HCV) infection was specifically associated with nonalcoholic fatty liver disease (NAFLD); 2) the factors associated with NAFLD in patients with HCV; and 3) the clinical and histological spectrum of NAFLD occurring together with HCV. METHODS: A retrospective analysis of 3826 biopsies was performed to compare the prevalence of NAFLD in those with HCV versus that in other liver diseases, e.g., hepatitis B, primary biliary cirrhosis, and alpha(1)-antitrypsin deficiency. Patients with HCV and NAFLD were also compared with an age- and gender-matched control group with HCV and <5% hepatic steatosis. RESULTS: The prevalence of NAFLD in patients with HCV was similar to that in hepatitis B, primary biliary cirrhosis, or alpha(1)-antitrypsin deficiency. The risk of having NAFLD in patients with HCV correlated with body weight (r = 0.7, p < 0.02). Compared with a control group with HCV alone (n = 75), patients with HCV and NAFLD (n = 69) were likely to be heavier (mean BMI 27 vs 30, p < 0.003), diabetic (eight vs 21, p < 0.005), hypertensive (14 vs 25, p < 0.05), and hypertriglyceridemic (15 vs 33, p < 0.05). The HCV viral load, genotype distribution, liver enzymes, liver functions, and ferritin levels were comparable across the study groups. Those with HCV and NAFLD were more likely to have advanced fibrosis (bridging fibrosis or cirrhosis) (26% vs 53%, p < 0.03). Weight, diabetes, and cytological ballooning were independent predictors of advanced fibrosis in those with HCV and NAFLD. CONCLUSIONS: The presence of NAFLD in patients with HCV is strongly associated with features of the metabolic syndrome and is a risk factor for advanced fibrosis. Advanced fibrosis in such patients is related to weight, presence of diabetes, and presence and degree of cytological ballooning. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/14499789/Nonalcoholic_fatty_liver_disease_in_patients_with_hepatitis_C_is_associated_with_features_of_the_metabolic_syndrome_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0002-9270&amp;date=2003&amp;volume=98&amp;issue=9&amp;spage=2064 DB - PRIME DP - Unbound Medicine ER -