Rigamonti C, Andorno S, Maduli E, Capelli F, Boldorini R, Sartori M
Internal Medicine Unit, University Amedeo Avogadro of East Piedmont, Novara, Italy.
Aliment Pharmacol Ther. 2005 Jun 15;21(12):1445-51. doi: 10.1111/j.1365-2036.2005.02517.x.
The role of gender in the progression of fibrosis in chronic hepatitis C is still under investigation.
To investigate whether gender affects the progression of liver disease and/or hides other risk factors.
A prospective series of 121 consecutive patients with chronic hepatitis C underwent liver biopsy. Grading and staging for chronic hepatitis were each evaluated according to Ishak's classification.
In univariate and multivariate analysis on the whole group of patients, male gender was not associated either with significant liver fibrosis (Ishak's score > 2) or with cirrhosis (Ishak's score > 4). On the contrary, in univariate analysis on patients aged < or = 50 years, male gender was nearly significantly (P = 0.06) predictive of liver fibrosis, whereas it was not in patients > 50 years. Hepatic iron grading, along with age, was an independent factor associated with fibrosis. Moreover, the values of all the variables which describe iron status were significantly higher in males aged < or = 50 years in comparison with females of the same age.
In chronic hepatitis C, male gender may be predictive of liver fibrosis only in patients aged < or = 50 years. Among fibrogenetic factors hidden by gender, iron status could play a major role.
性别在慢性丙型肝炎纤维化进展中的作用仍在研究中。
研究性别是否影响肝病进展和/或掩盖其他危险因素。
对121例连续的慢性丙型肝炎患者进行前瞻性研究并进行肝活检。慢性肝炎的分级和分期均根据伊沙克分类法进行评估。
在对所有患者的单因素和多因素分析中，男性与显著肝纤维化（伊沙克评分>2）或肝硬化（伊沙克评分>4）均无关联。相反，在对年龄≤50岁患者的单因素分析中，男性几乎显著（P = 0.06）预测肝纤维化，而在年龄>50岁的患者中则不然。肝铁分级与年龄一起是与纤维化相关的独立因素。此外，与同年龄女性相比，年龄≤50岁男性中所有描述铁状态的变量值均显著更高。
在慢性丙型肝炎中，仅在年龄≤50岁的患者中男性可能预测肝纤维化。在性别掩盖的促纤维化因素中，铁状态可能起主要作用。
