在法国慢性丙型肝炎患者中，肝纤维化与脂肪变性无关，而与坏死性炎症有关。
Liver fibrosis is not associated with steatosis but with necroinflammation in French patients with chronic hepatitis C.
作者信息
Asselah T, Boyer N, Guimont M-C, Cazals-Hatem D, Tubach F, Nahon K, Daïkha H, Vidaud D, Martinot M, Vidaud M, Degott C, Valla D, Marcellin P
机构信息
Centre de Recherche Claude Bernard sur les Hépatites Virales, AP-HP Hôpital Beaujon, Clichy, France. Service de Biochimie, AP-HP Hôpital Beaujon, Clichy, France.
出版信息
Gut. 2003 Nov;52(11):1638-43. doi: 10.1136/gut.52.11.1638.
BACKGROUND
In chronic hepatitis C, it has been suggested that steatosis could accelerate progression of fibrosis. However, results of the few published studies are controversial.
AIM
To determine the characteristics (epidemiological, biological, and histological) associated with steatosis and its relationship with liver lesions (grade of necroinflammation and stage of fibrosis) in patients with chronic hepatitis C.
METHODS
From November 2000 to July 2001, untreated consecutive adults with chronic hepatitis C admitted for liver biopsy were included in this study. On the day of liver biopsy, a questionnaire for risk factors was completed prospectively, and a blood sample was obtained for laboratory analysis.
RESULTS
Our study included 290 patients (143 men, 147 women). Mean body mass index (BMI) was 24 (3.8) kg/m(2). Proportions of patients with genotypes 1 and 3 were, respectively, 48% and 18%. A total of 135 patients (46.6%) had steatosis. Liver steatosis, in multivariate analysis, was associated with hepatitis C virus genotype 3, higher grade of necroinflammation, and higher BMI. There was no significant association between stage of fibrosis and liver steatosis. In multivariate analysis, high stage of fibrosis was associated with male sex, age over 50 years, high BMI, and high grade of necroinflammation.
CONCLUSION
In our population of patients with chronic hepatitis C, steatosis does not seem to be an important determinant of liver fibrosis. High grade of necroinflammation is associated with a high stage of fibrosis.
背景
在慢性丙型肝炎中，有观点认为脂肪变性可能会加速纤维化进程。然而，少数已发表研究的结果存在争议。
目的
确定慢性丙型肝炎患者中与脂肪变性相关的特征（流行病学、生物学和组织学）及其与肝脏病变（坏死炎症分级和纤维化分期）的关系。
方法
2000年11月至2001年7月，纳入因肝活检而入院的未经治疗的连续性成年慢性丙型肝炎患者。在肝活检当天，前瞻性地完成一份危险因素问卷，并采集血样进行实验室分析。
结果
我们的研究纳入了290例患者（143例男性，147例女性）。平均体重指数（BMI）为24（3.8）kg/m²。基因型1和3的患者比例分别为48%和18%。共有135例患者（46.6%）存在脂肪变性。在多因素分析中，肝脏脂肪变性与丙型肝炎病毒基因型3、更高的坏死炎症分级和更高的BMI相关。纤维化分期与肝脏脂肪变性之间无显著关联。在多因素分析中，高纤维化分期与男性、年龄超过50岁、高BMI和高坏死炎症分级相关。
结论
在我们的慢性丙型肝炎患者群体中，脂肪变性似乎不是肝纤维化的重要决定因素。高坏死炎症分级与高纤维化分期相关。
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