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Association of metabolic profiles with hepatic fibrosis in chronic hepatitis C patients with genotype 1 or 2 infection

Authors

  • Ching-Sheng Hsu,

    1. Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch, and School of Medicine, Tzu Chi University, Hualien, Taiwan,
    2. Graduate Institute of Clinical Medicine,
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  • Chen-Hua Liu,

    1. Graduate Institute of Clinical Medicine,
    2. Department of Internal Medicine, National Taiwan University Hospital,
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  • Chun-Jen Liu,

    1. Graduate Institute of Clinical Medicine,
    2. Department of Internal Medicine, National Taiwan University Hospital,
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  • Shih-Jer Hsu,

    1. Graduate Institute of Clinical Medicine,
    2. Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan
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  • Chi-Ling Chen,

    1. Graduate Institute of Clinical Medicine,
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  • Juey-Jen Hwang,

    1. Department of Internal Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan
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  • Ming-Yang Lai,

    1. Graduate Institute of Clinical Medicine,
    2. Department of Internal Medicine, National Taiwan University Hospital,
    3. Department of Medical Research, and
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  • Pei-Jer Chen,

    1. Department of Internal Medicine, National Taiwan University Hospital,
    2. Department of Medical Research, and
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  • Ding-Shinn Chen,

    1. Graduate Institute of Clinical Medicine,
    2. Department of Internal Medicine, National Taiwan University Hospital,
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  • Jia-Horng Kao

    Corresponding author
    1. Graduate Institute of Clinical Medicine,
    2. Department of Internal Medicine, National Taiwan University Hospital,
    3. Department of Medical Research, and
    4. Hepatitis Research Center, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, and
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  • Grant/Funding Support: This work was supported by grants from the National Taiwan University Hospital, National Taiwan University Hospital Yun-Lin Branch, Liver Disease Prevention & Treatment Research Foundation, the Department of Health, and the National Science Council, Executive Yuan, Taiwan.

  • Financial Disclosures: n/a.

  • Potential conflicts of interest: All authors: none.

Professor Jia-Horng Kao, Director and Distinguished Professor, Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei 10002, Taiwan. Email: kaojh@ntu.edu.tw

Abstract

Background and Aims:  Metabolic profiles are associated with severity of liver histology in chronic hepatitis C (CHC) infection. However, the influence of hepatitis C virus (HCV) genotypes, especially genotype 1 and 2, on the association between metabolic profiles and hepatic fibrosis remains unknown.

Methods:  We consecutively enrolled 528 CHC patients infected by HCV genotype 1 or 2, and used univariate and multivariate approaches to determine the influence of HCV genotype on the association of metabolic characteristics with severity of liver histology.

Results:  In univariate analysis, diabetes mellitus, obesity, higher grades of hepatic steatosis, homeostasis model assessment–insulin resistance index and alanine aminotransferase level, but lower serum total cholesterol and low-density lipoprotein level, were associated with advanced hepatic fibrosis. Advanced hepatic fibrosis was associated with an adjusted odds ratio of 13.72 (95% confidence interval, 2.15–87.7) for serum fasting blood glucose, 1.07 (1.01 to 1.13) for body mass index (BMI), and 0.03 (0.00–0.32) for total cholesterol level. Older age, lower serum total cholesterol level and more necro-inflammatory activity were associated with advanced hepatic fibrosis in both genotype 1 and 2 patients (P < 0.05). Advanced hepatic fibrosis was associated with an adjusted odds ratio of 31.18 (2.31–421.4) for fasting blood glucose level in genotype 1 infection, whereas 1.16 (1.05–1.28) for BMI in genotype 2 infection.

Conclusions:  Age, serum total cholesterol, and hepatic necro-inflammation have important associations with severity of hepatic fibrosis in CHC patients. Moreover, these associations are different between HCV genotype: the effects of fasting blood glucose level and BMI are increased on genotype 1 and genotype 2 patients, respectively.

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