Effects of metabolic syndrome on fibrosis in chronic viral hepatitis

Gut Liver. 2013 Jul;7(4):469-74. doi: 10.5009/gnl.2013.7.4.469. Epub 2013 Jun 20.

Effects of metabolic syndrome on fibrosis in chronic viral hepatitis

Yoon H, Lee JG, Yoo JH, Son MS, Kim DY, Hwang SG, Rim KS.

Source
Department of Internal Medicine, CHA University, Seongnam, Korea.

Key Words: Metabolic syndrome; Hepatitis B; Hepatitis C; Liver cirrhosis

Various studies have already reported the association between liver fibrosis and metabolic syndrome in nonalcoholic fatty liver disease (NAFLD) and found that the components of metabolic syndrome are independent risk factors of liver fibrosis.

There are relatively less data on chronic viral hepatitis, however. With regards to chronic hepatitis C (CHC), studies have reported that type 2 DM and other components of metabolic syndrome negatively affects the efficiency of antiviral treatments. According to previous report, the prevalence of diabetes and metabolic syndrome were raised in CHC patients, with accelerated progression of liver fibrosis. There are even less information regarding chronic hepatitis B (CHB) than CHC. Only a few preliminary data suggested association between the components of metabolic syndrome—obesity, diabetes, hypertension, and hyperlipidemia—and liver fibrosis in CHB.

The aim of this study was to determine the association between metabolic syndrome and liver fibrosis in CHB and CHC.....

Original Article- Full Text Available Here

Abstract
BACKGROUND/AIMS:
Metabolic syndrome, comprising diabetes, hypertension, central obesity, and dyslipidemia, is increasingly prevalent worldwide. We aimed to study the relationship between metabolic syndrome and the risk of liver fibrosis in patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC).

METHODS:
In total, 954 patients (CHB, 850; CHC, 104 patients) with liver biopsy were included in the retrospective analysis. Extensive clinical and histological data were available. Metabolic syndrome was defined using the International Diabetes Federation definition of metabolic syndrome, 2006 criteria. Histological lesions were evaluated according to the histology activity index system.

RESULTS:
Metabolic syndrome was present in 6% of patients and significantly more prevalent in patients with CHC than in patients with CHB (5% vs 13%, p<0.001). Patients with metabolic syndrome were older among patients with CHB and patients with CHC, and, as expected, were mainly overweight or obese. Fibrosis was significantly more severe in patients with metabolic syndrome than in those without, regardless of whether they had CHB and CHC (CHB, 3.3±2.1 vs 2.4±1.3, p=0.025; CHC, 2.6±1.5 vs 1.3±0.7, p=0.006). Liver fibrosis (stages 3 to 4) was independently associated with increased age, higher transaminase level and metabolic syndrome (odds ratio, 2.421; p=0.017).

CONCLUSIONS:
Metabolic syndrome is associated independently with severe fibrosis in patients with chronic viral hepatitis B and C.

 Gut and Liver 2013 Jul; 7(4): 469-474/ Download PDF Here