Interplay between oxidative stress and hepatic steatosis in the progression of chronic hepatitis C

J Hepatol. 2008 Mar;48(3):399-406. doi: 10.1016/j.jhep.2007.10.011. Epub 2007 Dec 3.

Abstract

Background/aims: The contribution of oxidative stress to the pathogenesis of chronic hepatitis C (CHC) is still poorly elucidated. This study investigated the relationship between oxidative stress, insulin resistance, steatosis and fibrosis in CHC.

Methods: IgG against malondialdehyde-albumin adducts and HOMA-IR were measured as markers of oxidative stress and insulin resistance, respectively, in 107 consecutive CHC patients.

Results: Oxidative stress was present in 61% of the patients, irrespective of age, gender, viral load, BMI, aminotransferase level, histology activity index (HAI) and HCV genotype. Insulin resistance and steatosis were evident in 80% and 70% of the patients, respectively. In the patients infected by HCV genotype non-3, but not in those with genotype 3 infection HOMA-IR (p<0.03), steatosis (p=0.02) and fibrosis (p<0.05) were higher in the subjects with oxidative stress than in those without. Multiple regression analysis revealed that, HOMA-IR (p<0.01), fibrosis (p<0.01) and oxidative stress (p<0.05) were independently associated with steatosis, whereas steatosis was independently associated with oxidative stress (p<0.03) and HOMA-IR (p<0.02). Steatosis (p<0.02) and HAI (p=0.007) were also independent predictors of fibrosis.

Conclusions: In patients infected by HCV genotype non-3, oxidative stress and insulin resistance contribute to steatosis, which in turn exacerbates both insulin resistance and oxidative stress and accelerates the progression of fibrosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Case-Control Studies
  • Disease Progression
  • Fatty Liver / physiopathology*
  • Female
  • Hepatitis C, Chronic / etiology
  • Hepatitis C, Chronic / physiopathology*
  • Humans
  • Immunoglobulin G / blood
  • Insulin Resistance / physiology
  • Liver Cirrhosis / physiopathology
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Oxidative Stress / physiology*
  • Predictive Value of Tests

Substances

  • Immunoglobulin G