Hepatic steatosis and insulin resistance are associated with serum imbalance of adiponectin/tumour necrosis factor-α in chronic hepatitis C patients


Prof. L. E. Adinolfi, Medicina Interna ed Epatologia, Seconda Università di Napoli – Ospedale Gesù e Maria, Via Cotugno 1, 80135 Napoli, Italy.
E-mail: luigielio.adinolfi@unina2.it




Steatosis and insulin resistance (IR) have a pathogenic role in chronic hepatitis C (HCV). Adipocytokines balance modulates hepatic lipid content and IR.


To evaluate serum adipocytokines and relationship with virological, histological and metabolic parameters in chronic HCV.


Adiponectin and tumour necrosis factor-α (TNF-α) levels, HCV genotypes, HCV-RNA, IR (HOMA-IR), body mass index and liver steatosis and fibrosis were assessed in 161 non-diabetic chronic HCV patients.


Chronic HCV patients with steatosis showed lower serum adiponectin levels and higher levels of TNF-α, HOMA, alanine aminotransferase, γ-glutamiltransferase and Histological Activity Index (HAI) and fibrosis scores. Low adiponectin levels were independently associated with grades of steatosis and HOMA-IR. Higher tumour necrosis factor-α levels were observed in patients with low adiponectin levels. The extension of steatosis was inversely correlated with adiponectin levels. A correlation between grade of steatosis with HOMA-IR and fibrosis was observed. HCV genotype 3-infected patients showed lower adiponectin levels than those with other genotypes. An independent predictor of low adiponectin levels in genotype 3 infection was the extension of steatosis. Liver fibrosis score was associated with steatosis, HAI and age.


Chronic HCV patients with steatosis showed a serum adiponectin/TNF-α imbalance that is associated with IR. Reduced adiponectin levels may be involved in the pathogenesis of steatosis, which in turn accelerates progression of fibrosis in chronic HCV.