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Abstract
Background :
Liver steatosis is a common finding in patients infected with hepatitis C virus (HCV).
Host and viral factors have been associated with steatosis , but their relative contributions have not been clearly addressed. It has been suggested that steatosis plays a role in the progression of liver fibrosis.
Aim:
To assess factors associated with steatosis in Egyptian patients with chronic HCV infection and to assess the impact of insulin resistance levels (as HOMA score) and Leptin levels on liver steatosis, relative to other factors.
Patients and methods :
This study was conducted on fifty five cases of chronic HCV hepatitis as well as fifteen healthy subjects without evidence of chronic liver disease. They were clinically assessed and investigated ( Laboratory including complete blood count,liver biochemical profile, lipid profile, fasting blood glucose, serum insulin, HOMA
IR and serum leptin , imaging by abdominal ultrasonography and Histopathologically according to modified Knodell score ). Body mass index was assessed.
Logistic regression and multivariate analysis were used to identify variables independently associated with steatosis.
Results:
The frequency of hepatic steatosis was 54.5%. In univariate analysis, steatosis was associated with elevated BMI (P= 0.007), age (P= 0.008), high serum triglycerides(P= 0.005) and high fibrosis stage (P= 0.03). Multivariate analysis revealed that BMI is a good predictor for steatosis (β= 0.13 , P=0.04) while age and triglyceride are no
more predictors (P= 0.06 and 0.09 respectively). Serum leptin was significantly
higher in chronic HCV patients with steatosis than control group(17.05±17.69 ng/ml vs 7.44±7.95 ng/ml in the control group, P value <0.02 ). Serum leptin level in Chronic HCV patients with steatosis was relatively higher than Chronic HCV patients without steatosis, but the difference did not reach a statistical significance. There was no statistically significant difference between the studied groups as regard fasting blood sugar, serum insulin and insulin resistance.
Conclusion:
Hepatic steatosis is common in patients with chronic HCV hepatitis. Factors
associated with hepatic steatosis are BMI, age of the patient, serum TGs and stage of fibrosis. BMI is the only predictor of hepatic steatosis. There is no significant correlation between IR, leptin and incidence of hepatic steatosis.