Overweight and Obesity, Hepatic Steatosis, and Progression of Chronic Hepatitis C: A Retrospective Study on a Large Cohort of Patients in the United States

J Hepatol. 2004 Jan;40(1):147-54. doi: 10.1016/s0168-8278(03)00479-3.


Background: Hepatic steatosis has been associated with chronic hepatitis C (CHC), but its prevalence, risk factors, and clinical significance remain to be determined.

Aims: The present study determined the frequency of, and risk factors for hepatic steatosis and its association with activity and progression of CHC in a large cohort of U.S. patients.

Methods: This is a retrospective study that utilized systematic chart review and statistical analyzes to investigate 324 U.S. patients with CHC from a university medical center and a regional VA medical center.

Results: The frequency of hepatic steatosis was 66.0%. We demonstrated that not only being obese, but also overweight (i.e. body mass index > or =25 kg/m(2)) was independently associated with hepatic steatosis. In our cohort of patients with CHC, hepatic steatosis, especially grade II/III steatosis, was significantly associated with elevated aspartate aminotransferase at entry, persistently elevated alanine aminotransferase, and stage III/IV fibrosis. Grade II/III steatosis, was significantly associated with a higher histology activity index as well. Multivariate analysis indicated that steatosis, especially grade II/III steatosis, was independently associated with stage III/IV fibrosis.

Conclusions: Being overweight/obese serves as an independent risk factor for hepatic steatosis in U.S. patients with CHC. Steatosis accelerates activity and progression of CHC, and is independently associated with stage III/IV hepatic fibrosis in these patients.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Body Mass Index
  • Cohort Studies
  • Demography
  • Disease Progression
  • Fatty Liver / enzymology
  • Fatty Liver / epidemiology
  • Fatty Liver / etiology*
  • Female
  • Hepatitis C, Chronic / complications*
  • Hepatitis C, Chronic / physiopathology
  • Humans
  • Incidence
  • Liver Cirrhosis / etiology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Obesity / complications*
  • Obesity / pathology
  • Prevalence
  • Retrospective Studies
  • Risk Factors
  • United States / epidemiology


  • Aspartate Aminotransferases
  • Alanine Transaminase