Association of metabolic profiles with hepatic fibrosis in chronic hepatitis C patients with genotype 1 or 2 infection.

BACKGROUND AND AIMS

Metabolic profiles are associated with severity of liver histology in chronic hepatitis C (CHC) infection. However, the influence of hepatitis C virus (HCV) genotypes, especially genotype 1 and 2, on the association between metabolic profiles and hepatic fibrosis remains unknown.

METHODS

We consecutively enrolled 528 CHC patients infected by HCV genotype 1 or 2, and used univariate and multivariate approaches to determine the influence of HCV genotype on the association of metabolic characteristics with severity of liver histology.

RESULTS

In univariate analysis, diabetes mellitus, obesity, higher grades of hepatic steatosis, homeostasis model assessment-insulin resistance index and alanine aminotransferase level, but lower serum total cholesterol and low-density lipoprotein level, were associated with advanced hepatic fibrosis. Advanced hepatic fibrosis was associated with an adjusted odds ratio of 13.72 (95% confidence interval, 2.15-87.7) for serum fasting blood glucose, 1.07 (1.01 to 1.13) for body mass index (BMI), and 0.03 (0.00-0.32) for total cholesterol level. Older age, lower serum total cholesterol level and more necro-inflammatory activity were associated with advanced hepatic fibrosis in both genotype 1 and 2 patients (P < 0.05). Advanced hepatic fibrosis was associated with an adjusted odds ratio of 31.18 (2.31-421.4) for fasting blood glucose level in genotype 1 infection, whereas 1.16 (1.05-1.28) for BMI in genotype 2 infection.

CONCLUSIONS

Age, serum total cholesterol, and hepatic necro-inflammation have important associations with severity of hepatic fibrosis in CHC patients. Moreover, these associations are different between HCV genotype: the effects of fasting blood glucose level and BMI are increased on genotype 1 and genotype 2 patients, respectively.