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Obesity and non-alcoholic fatty liver disease in chronic hepatitis C.
J Clin Gastroenterol 2004; 38(8):705-9JC

Abstract

BACKGROUND

Superimposed non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) may affect HCV-related fibrosis. We performed a study to determine the relationship between NAFLD and chronic hepatitis C.

METHODS

One hundred and twenty patients with chronic hepatitis C and available liver biopsies were included. Baseline liver biopsies were read by 1 hepatopathologist using Metavir, as well as a fatty liver pathology protocol. Patients' baseline clinical, demographic, and virologic data were associated with the extent of steatosis (>33% vs. < or =33%), the type of fatty liver (no steatosis vs. steatosis only vs. NASH), and the stage of fibrosis seen on the liver biopsy.

RESULTS

Seventy percent of patients were men and 80% were white. The mean age was 47.48+/-5.70 years, mean BMI was 29.01 +/-5.01 kg/m, and mean waist to hip ratio (W/H) was 0.90+/-0.08. Patients with higher grade of steatosis had higher BMI (32.83+/-6.26 vs. 28.49+/-4.62, P = 0.034), more likely to have genotype 3 (21.4% vs. 5.7%, P = 0.037) and advanced fibrosis (92.9% vs. 62.3%, P = 0.033) than those with lower grade of steatosis. Of these, only HCV-genotype 3 remained independently associated with higher grade of steatosis. When patients with superimposed NASH (n = 22) were compared with those with only steatosis (n = 49) and those without steatosis (n = 49), patients with superimposed NASH had more evidence of obesity (BMI: 30.64+/-5.23 vs. 29.90+/-5.35 vs. 27.33+/-4.07, P = 0.008; W/H: 0.97+/-0.06 vs. 0.91+/-0.08 vs. 0.87+/-0.07, P < 0.001), more commonly infected with HCV genotype 3 (14% vs. 12% vs. 0%, P = 0.036) and had more advanced fibrosis (95.5% vs. 75.5% vs. 42.9%, P < 0.001). Race, gender, and age did not affect extent of steatosis or presence of superimposed NASH.

CONCLUSION

In conclusion, markers of obesity (BMI and W/H) and HCV genotype 3 are associated with the extent of steatosis and type of fatty liver. Higher grade of steatosis and presence of superimposed NASH are both associated with advanced hepatic fibrosis.

Authors+Show Affiliations

Center for Liver Diseases at Inova Fairfax Hospital, Falls Church, Virginia 22042, USA. zobair.younossi@inova.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15319656

Citation

Younossi, Zobair M., et al. "Obesity and Non-alcoholic Fatty Liver Disease in Chronic Hepatitis C." Journal of Clinical Gastroenterology, vol. 38, no. 8, 2004, pp. 705-9.
Younossi ZM, McCullough AJ, Ong JP, et al. Obesity and non-alcoholic fatty liver disease in chronic hepatitis C. J Clin Gastroenterol. 2004;38(8):705-9.
Younossi, Z. M., McCullough, A. J., Ong, J. P., Barnes, D. S., Post, A., Tavill, A., ... Ferguson, R. (2004). Obesity and non-alcoholic fatty liver disease in chronic hepatitis C. Journal of Clinical Gastroenterology, 38(8), pp. 705-9.
Younossi ZM, et al. Obesity and Non-alcoholic Fatty Liver Disease in Chronic Hepatitis C. J Clin Gastroenterol. 2004;38(8):705-9. PubMed PMID: 15319656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obesity and non-alcoholic fatty liver disease in chronic hepatitis C. AU - Younossi,Zobair M, AU - McCullough,Arthur J, AU - Ong,Janus P, AU - Barnes,David S, AU - Post,Anthony, AU - Tavill,Anthony, AU - Bringman,Diane, AU - Martin,Lisa M, AU - Assmann,Jennifer, AU - Gramlich,Terry, AU - Mullen,Kevin D, AU - O'Shea,Robert, AU - Carey,William D, AU - Ferguson,Roy, PY - 2004/8/21/pubmed PY - 2004/12/16/medline PY - 2004/8/21/entrez SP - 705 EP - 9 JF - Journal of clinical gastroenterology JO - J. Clin. Gastroenterol. VL - 38 IS - 8 N2 - BACKGROUND: Superimposed non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) may affect HCV-related fibrosis. We performed a study to determine the relationship between NAFLD and chronic hepatitis C. METHODS: One hundred and twenty patients with chronic hepatitis C and available liver biopsies were included. Baseline liver biopsies were read by 1 hepatopathologist using Metavir, as well as a fatty liver pathology protocol. Patients' baseline clinical, demographic, and virologic data were associated with the extent of steatosis (>33% vs. < or =33%), the type of fatty liver (no steatosis vs. steatosis only vs. NASH), and the stage of fibrosis seen on the liver biopsy. RESULTS: Seventy percent of patients were men and 80% were white. The mean age was 47.48+/-5.70 years, mean BMI was 29.01 +/-5.01 kg/m, and mean waist to hip ratio (W/H) was 0.90+/-0.08. Patients with higher grade of steatosis had higher BMI (32.83+/-6.26 vs. 28.49+/-4.62, P = 0.034), more likely to have genotype 3 (21.4% vs. 5.7%, P = 0.037) and advanced fibrosis (92.9% vs. 62.3%, P = 0.033) than those with lower grade of steatosis. Of these, only HCV-genotype 3 remained independently associated with higher grade of steatosis. When patients with superimposed NASH (n = 22) were compared with those with only steatosis (n = 49) and those without steatosis (n = 49), patients with superimposed NASH had more evidence of obesity (BMI: 30.64+/-5.23 vs. 29.90+/-5.35 vs. 27.33+/-4.07, P = 0.008; W/H: 0.97+/-0.06 vs. 0.91+/-0.08 vs. 0.87+/-0.07, P < 0.001), more commonly infected with HCV genotype 3 (14% vs. 12% vs. 0%, P = 0.036) and had more advanced fibrosis (95.5% vs. 75.5% vs. 42.9%, P < 0.001). Race, gender, and age did not affect extent of steatosis or presence of superimposed NASH. CONCLUSION: In conclusion, markers of obesity (BMI and W/H) and HCV genotype 3 are associated with the extent of steatosis and type of fatty liver. Higher grade of steatosis and presence of superimposed NASH are both associated with advanced hepatic fibrosis. SN - 0192-0790 UR - https://www.unboundmedicine.com/medline/citation/15319656/Obesity_and_non_alcoholic_fatty_liver_disease_in_chronic_hepatitis_C_ L2 - http://Insights.ovid.com/pubmed?pmid=15319656 DB - PRIME DP - Unbound Medicine ER -