Friday, August 2, 2013

Association of Visceral Obesity with High Viral Load and Histological Findings in Elderly Patients with Genotype 1 Chronic Hepatitis C

Internal Medicine
Vol. 52 (2013) No. 15 p. 1665-1673

Association of Visceral Obesity with High Viral Load and Histological Findings in Elderly Patients with Genotype 1 Chronic Hepatitis C

Hironori Tsuzura1), Takuya Genda1), Shunsuke Sato1), Katsuharu Hirano1), Yoshio Kanemitsu1), Yutaka Narita1), Tetsu Kikuchi1), Katsuyori Iijima1), Ryo Wada2), Takafumi Ichida1)
1) Department of Gastroenterology and Hepatology, Juntendo University Shizuoka Hospital, Japan 2) Department of Pathology, Juntendo University Shizuoka Hospital, Japan Released on J-STAGE 20130801

Keywords: chronic hepatitis C, visceral obesity, viral load, steatosis, fibrosis, adiponectin
...visceral obesity was found to be associated with high viral load, steatosis , and age-dependent fibrosis progression in patients with  genotype 1 chronic hepatitis C.....

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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.

Conclusion Visceral obesity was associated with high viral load and histological damage in elderly patients with reduced adiponectin levels.

Visceral obesity
Type: Term
1. a form of obesity due to excessive deposition of fat in the abdominal viscera and omentum, rather than subcutaneously, associated with dyslipidemia (increased plasma triglyceride, low high-density lipoprotein cholesterol); perhaps due to accelerated lipolysis and mobilization of abdominal fatty acids by way of the portal vein; poses greater risk of diabetes mellitus, hypertension, metabolic syndrome, and cardiovascular disease than peripheral obesity does.

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