Adinolfi L E, Durante-Mangoni E, Zampino R, Ruggiero G
Internal Medicine and Hepatology, Second University of Naples, Naples, Italy.
Aliment Pharmacol Ther. 2005 Nov;22 Suppl 2:52-5. doi: 10.1111/j.1365-2036.2005.02597.x.
Steatosis is a common feature of chronic hepatitis C, and may be caused directly by the virus, as in genotype 3 infection, or be associated with host metabolic factors. The interaction of hepatitis C virus core protein with the lipoprotein secretion pathways causes the characteristic alterations of lipid metabolism observed in hepatitis C virus-related steatosis. Several pathogenic mechanisms are likely involved into the pathogenesis of hepatitis C virus-related steatosis, including hyper-homocysteinaemia, hypoadiponectinaemia and insulin resistance. Steatosis is a major determinant of the liver damage progression in chronic hepatitis C (CHC), and negatively affects the response rate to the interferon (IFN)-based anti-viral treatment. Moreover, recent evidence suggests that steatosis may contribute to liver carcinogenesis. Chronic hepatitis C is a recognized risk factor for type 2 diabetes and it could be implicated into the pathogenesis of atherosclerosis. The role of hepatitis C virus (HCV)-related steatosis in these epidemiological associations remains to be determined.
脂肪变性是慢性丙型肝炎的常见特征，可能由病毒直接引起，如在基因3型感染中，或与宿主代谢因素有关。丙型肝炎病毒核心蛋白与脂蛋白分泌途径的相互作用导致了丙型肝炎病毒相关脂肪变性中观察到的脂质代谢特征性改变。丙型肝炎病毒相关脂肪变性的发病机制可能涉及多种致病机制，包括高同型半胱氨酸血症、低脂联素血症和胰岛素抵抗。脂肪变性是慢性丙型肝炎（CHC）肝损伤进展的主要决定因素，并对基于干扰素（IFN）的抗病毒治疗的反应率产生负面影响。此外，最近的证据表明脂肪变性可能促进肝癌发生。慢性丙型肝炎是2型糖尿病的公认危险因素，可能与动脉粥样硬化的发病机制有关。丙型肝炎病毒（HCV）相关脂肪变性在这些流行病学关联中的作用仍有待确定。
