back to 2011, vol. 17, b. 1

Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski, Gospodin Iliev
ISSN: 1312 773X (Online)
Issue: 2011, vol. 17, book 1
Subject Collection: Medicine
Page: 193-196
DOI: 10.5272/jimab.2011171.193
Online date: December 29, 2011

J of IMAB 2011; 17(1):193-196
METABOLIC FACE OF CHRONIC HEPATITIS B AND C IN BULGARIA
Krasimir Antonov1, Dejan Jelev1, Radina Ivanova2, Assen Alexiev1, Sonya Dragneva1, Luydmila Mateva1
1 Clinic of Gastroenterology, 2 Laboratory of clinival pathology, University Hospital “St. Ivan Rilski, Medical University, Sofia, Bulgaria

ABSTRACT:
It is well known that NAFLD, as well as diabetes mellitus (DM), correlated with the progression of liver fibrosis in chronic hepatitis C (CHC). The impact of NAFLD overlap in chronic hepatitis B (CHB)  is not well established.
Aim. In this study we compared the prevalence of NAFLD and related metabolic parameters in CHC and CHB, and their relationship with disease activity and fibrosis. 
Methods. The parameters of metabolic syndrome (MetS), glucose, insulin, HOMA-IR and histological features of steatosis / steatohepatitis were investigated in total of 700 patients with chronic viral hepatitis - CHB (n=334) and genotype 1 CHC (n=366). Glucose and insulin were also assessed during OGTT (60 and 120 min.) in 100 cases with CHB and 100 – with CHC.   
Results. Nonalcoholic metabolic related steatosis was more frequent (62% v/s 48%) and severe in CHC compared to CHB (p<0.01). MetS (51% v/s 33%), and DM OGTT (30% v/s 20%) were found also in higher frequency in CHC than in cases with CHB (р<0.001). In the both type hepatitis insulin resistance was associated with disease activity. In CHC, but not in CHB, a positive correlation between the degree of steatosis and the activity score was found (r = 0.322, p<0.05). In 70% of the cases with CHB and severe steatosis (>66%) HBV DNA was negative or <10 000 copies/ml. The advanced liver fibrosis (F3-F4) was associated with moderate or severe steatosis (CHC), as well as with the glucose levels, markers of insulin resistance, and presence of DM (p<0.001), but not with the other components of metabolic syndrome.
In conclusion, nonalcoholic metabolic related steatosis, diabetes mellitus and insulin resistance are associated with the both viral hepatitis, but the prevalence is higher in chronic hepatitis C. The degree of steatosis correlates with the activity grade and stage of fibrosis only in patients with chronic hepatitis C. Insulin resistance and diabetes mellitus are associated with more advanced liver fibrosis in the both viral hepatitis

Key words: hepatic steatosis, metabolic syndrome, insulin resistance, diabetes mellitus, chronic hepatitis C, chronic hepatitis B.

- Download FULL TEXT (PDF - 139 KB)

REFERENCES:
1. Fartoux L, Poujol-Robert A, Guechot J, Wendum D, Poupon R, Serfaty L. Insulin resistance is a cause of steatosis and fibrosis progression in chronic hepatitis C. Gut 2005 Jul;54(7): 1003-8. [PubMed]
2. Leandro G, Mangia A, Hui J, Fabris P, Rubbia-Brandt L, Colloredo G, et al. Relationship between steatosis, inflammation, and fibrosis in chronic Hepatitis C: a meta-analysis of individual patient data. Gastroenterology. 2006 May;130(6):1346-62. [CrossRef] [PubMed]
3. Cammà C, Bruno S, Di Marco V, Di Bona D, Rumi M, Vinci M,  et al. Insulin resistance is associated with steatosis in nondiabetic patients with genotype 1 chronic hepatitis C. Hepatology. 2006 Jan;43(1):64-71. [CrossRef] [PubMed]
4. Persico M, Iolascon A. Steatosis as a co-factor in chronic liver diseases. World J Gastroenterol. 2010 Mar;16(10):1171-6. [CrossRef] [PubMed]
5. Brunt EM, Janney CG, Di Bisceglie AM, Neuschwander-Tetri BA, Bacon BR. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol 1999 Sep; 94(9): 2467–2474. [CrossRef] [PubMed]
6. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985 Jul;28(7): 412-419. [PubMed]
7. Ricardo A, DeUgarte CM, Chen Y-DI. What's the best way to diagnose insulin resistance and hyperinsulinemia? Contemporary OB/GYN 2005; 50: 66-74.
8. Peng D, Han Y, Ding H, Wei L. Hepatic steatosis in chronic hepatitis B patients is associated with metabolic factors more than viral factors. J Gastroenterol Hepatol 2008 Jul;23(7 Pt 1):1082-1088. [CrossRef] [PubMed]
9. Bondini S, Kallman J, Wheeler A, Prakash S, Gramlich T, Jondle DM, Younossi ZM. Impact of non-alcoholic fatty liver disease on chronic hepatitis B. Liver Int 2007 Jun;27(5):607-611. [CrossRef][PubMed]
10. Zheng RD, Xu CR, Jiang L, Dou AX, Zhou K, Lu LG. Predictors of hepatic steatosis in HBeAg-negative chronic hepatitis B patients and their diagnostic values in hepatic fibrosis. Int J Med Sci. 2010 Aug 11;7(5):272-7. [PubMed]
11. Asselah T, Rubbia-Brandt L, Marcellin P, Negro F. Steatosis in chronic hepatitis C: why does it really matter? Gut 2006 Jan;55(1):123-130. [PubMed]
12. Hourigan LF, Macdonald GA, Purdie D, Whitehall VH, Shorthouse C, Clouston A, Powell EE. Fibrosis in chronic hepatitis C correlates significantly with body mass index and steatosis Hepatology 1999 Apr;29(4):1215-9. [CrossRef] [PubMed]
13. Adinolfi LE, Gambardella M, Andreana A, Tripodi MF, Utili R, Ruggiero G. Steatosis accelerates the progression of liver damage of chronic hepatitis C patients and correlates with specific HCV genotype and visceral obesity. Hepatology 2001 Jun;33(6):1358–64. [PubMed] [CrossRef]
14. Machado MV, Cortez-Pinto H. Insulin resistance and steatosis in chronic hepatitis C. Ann Hepatol. 2009; 8 (Suppl 1):S67-75. [PubMed]
15. Papatheodoridis GV, Chrysanthos N, Savvas S, Sevastianos V, Kafiri G, Petraki K, Manesis EK. Diabetes mellitus in chronic hepatitis B and C: prevalence and potential association with the extent of liver fibrosis. J Viral Hepat; 2006 May;13(5):303–310. [PubMed] [CrossRef]
16. Paradis V, Perlemuter G, Bonvoust F, Dargere D, Parfait B, Vidaud M, et al. High glucose and hyperinsulinemia stimulate connective tissue growth factor expression: a potential mechanism involved in progression to fibrosis in nonalcoholic steatohepatitis. Hepatology 2001 Oct;34(4 Pt 1):738–744. [PubMed] [CrossRef]
17. Wong GL, Wong VW, Choi PC, Chan AW, Chim AM, Yiu KK, et al. Metabolic syndrome increases the risk of liver cirrhosis in chronic hepatitis B. Gut. 2009 Jan;58(1):111-117. Epub 2008 Oct 2. [PubMed] [CrossRef].

Please cite this article as: Antonov Kr, Jelev D, Ivanova R, Alexiev A, Dragneva S, Mateva L. METABOLIC FACE OF CHRONIC HEPATITIS B AND C IN BULGARIA. J of IMAB. 2011; 17(1):193-196. doi:10.5272/jimab.2011171.193

back to Online Journal