Giannini E, Ceppa P, Botta F, Mastracci L, Romagnoli P, Comino I, Pasini A, Risso D, Lantieri P B, Icardi G, Barreca T, Testa R
Department of Internal Medicine, University of Genoa, Italy.
Am J Gastroenterol. 2000 Nov;95(11):3211-7. doi: 10.1111/j.1572-0241.2000.03294.x.
The presence of steatosis is a common histological finding in patients with chronic hepatitis C (CHC). The causes of the severity of this condition are not yet clear, although both metabolic and viral factors supposedly are involved. In this study our aim was to examine the possible influence that leptin levels, hepatitis C virus (HCV) RNA levels, and hepatitis G virus (HGV) infection have on the severity of steatosis and on the presence and degree of fibrosis in patients with CHC.
One hundred eighty-two CHC patients with histological findings of steatosis were chosen from among a cohort of patients referred to our center for staging of liver disease. Among them 48 CHC patients were accurately selected so as to rule out possible confounding factors for the presence of steatosis (diabetes mellitus, hyperlipemia, obesity, alcohol). Leptin levels, HCV RNA levels, and HCV genotype, and the presence of HGV RNA were assessed in these patients and related to histological findings.
We found that leptin levels in CHC patients were similar to those in healthy subjects. No relationship was found between leptin levels and severity of steatosis. HCV RNA levels, HCV genotype, and the presence of HGV infection were no different among CHC patients with various degrees of steatosis. Leptin was not related to different degrees of fibrosis, whereas higher viral load was the only parameter associated to higher fibrosis scores.
These findings suggest that the degree of steatosis in patients with CHC does not seem to depend on serum leptin levels or on viral factors, at least as far as HCV viremia and genotype and HGV infection are concerned. The severity of fibrosis does not seem to be influenced by leptin levels, whereas HCV viral load does seem to play some role.
脂肪变性是慢性丙型肝炎（CHC）患者常见的组织学表现。尽管代谢和病毒因素可能都与之相关，但这种情况严重程度的病因尚不清楚。在本研究中，我们的目的是探讨瘦素水平、丙型肝炎病毒（HCV）RNA水平和庚型肝炎病毒（HGV）感染对CHC患者脂肪变性严重程度以及纤维化的存在和程度可能产生的影响。
从转诊至我们中心进行肝病分期的患者队列中选取182例有脂肪变性组织学表现的CHC患者。其中准确挑选出48例CHC患者，以排除脂肪变性存在的可能混杂因素（糖尿病、高脂血症、肥胖、酒精）。对这些患者评估瘦素水平、HCV RNA水平、HCV基因型以及HGV RNA的存在情况，并将其与组织学结果相关联。
我们发现CHC患者的瘦素水平与健康受试者相似。未发现瘦素水平与脂肪变性严重程度之间存在关联。不同程度脂肪变性的CHC患者之间，HCV RNA水平、HCV基因型以及HGV感染情况并无差异。瘦素与不同程度的纤维化无关，而较高的病毒载量是与较高纤维化评分相关的唯一参数。
这些发现表明，CHC患者的脂肪变性程度似乎不取决于血清瘦素水平或病毒因素，至少就HCV病毒血症、基因型和HGV感染而言是这样。纤维化的严重程度似乎不受瘦素水平影响，而HCV病毒载量似乎确实起了一定作用。
