Hyperuricaemia: another metabolic feature affecting the severity of chronic hepatitis because of HCV infection
Article first published online: 5 JUL 2012
© 2012 John Wiley & Sons A/S
Volume 32, Issue 9, pages 1443–1450, October 2012
How to Cite
Petta, S., Macaluso, F. S., Cammà, C., Marco, V. D., Cabibi, D. and Craxì, A. (2012), Hyperuricaemia: another metabolic feature affecting the severity of chronic hepatitis because of HCV infection. Liver International, 32: 1443–1450. doi: 10.1111/j.1478-3231.2012.02842.x
- Issue published online: 3 SEP 2012
- Article first published online: 5 JUL 2012
- Manuscript Accepted: 2 JUN 2012
- Manuscript Received: 17 DEC 2011
- chronic hepatitis C;
- uric acid
Several works observed a link between uric acid serum levels and clinical and histological features of nonalcoholic fatty liver disease. An association between chronic hepatitis C (CHC) and uric acid levels has been poorly investigated.
To assess the potential association between uric acid serum levels and both histological features of liver damage and sustained virological response (SVR) in a homogeneous cohort of CHC patients.
Consecutive biopsy-proven CHC patients were included. Hyperuricaemia was diagnosed with uric acid serum levels >7 mg/dl in men, and >6 mg/dl in women. Patients underwent therapy with pegylated interferon plus ribavirin.
Hyperuricaemia, observed in 7.5% of patients, was associated with low density lipoprotein cholesterol (OR 1.015, 95% CI 1.004–1.026, P = 0.008), arterial hypertension (OR 3.024, 95% CI 1.290–7.088, P = 0.01), estimated glomerular filtration rate (OR 0.942, 95% CI 0.919–0.965, P < 0.001) and severity of steatosis (OR 3.176, 95% CI 1.828–5.517, P < 0.001) by multivariate logistic regression analysis. The following features were independently linked to the severity of liver steatosis (<5% vs. ≥5% to <30% vs. ≥30%) using ordinal regression analysis: age (OR 1.027, 95% CI 1.011–1.044, P = 0.01), body mass index (OR 1.088, 95% CI 1.039–1.138, P < 0.001), triglycerides (OR 1.005, 95% CI 1.001–1.009, P = 0.02), homeostasis model assessment (OR 1.095, 95% CI 1.014–1.184, P = 0.02), hyperuricaemia (OR 2.751, 95% CI 1.423–5.322, P = 0.003), hepatitis C virus genotype 3 (OR 4.567, 95% CI 1.515–13.763, P = 0.007) and severe necroinflammatory activity (OR 1.584, 95% CI 1.067–2.349, P = 0.02). No independent association was found among uric acid levels and necroinflammatory activity, fibrosis and SVR.
In CHC patients, hyperuricaemia was independently associated with severity of steatosis, representing, in this setting, via steatosis induction, an indirect factor affecting both liver damage and poor response to therapy, and thus a novel potential therapeutic target in CHC management.