Published online Jan 8, 2016. doi: 10.4254/wjh.v8.i1.74
Peer-review started: July 31, 2015
First decision: September 29, 2015
Revised: October 19, 2015
Accepted: December 18, 2015
Article in press: December 21, 2015
Published online: January 8, 2016
AIM: To identify patients with or without liver steatosis and its severity in treatment-naïve patients affected by hepatitis C virus (HCV) infection.
METHODS: We included 56 HCV infected patients, and assessed the amount of liver fat by histomorphometry, and its relationships with fat and lean mass at different parts of the body (by densitometry), hormones [insulin, homeostatic model assessment (HOMA)], adipokines (resistin, adiponectin, leptin), and cytokines (tumor necrosis factor α, interleukin-6).
RESULTS: Although the intensity of liver steatosis is related to trunk fat mass and HOMA, 33% of patients showed no liver steatosis, and this finding was not related to body mass index or genotype. Besides trunk fat mass, no other factor was related to the presence or not of liver steatosis, or to the intensity of it, by multivariate analysis. Lean mass was not related to liver steatosis. Adiponectin levels were lower among patients. No differences were observed in leptin and resistin.
CONCLUSION: Steatosis in HCV infection is common (67.2%), and closely related to trunk fat, and insulin resistance, but not with leg fat mass or adipokines.
Core tip: Pathogenesis of liver steatosis in hepatitis C virus (HCV) infection is complex and is not fully understood. For unknown reasons some patients, despite having a high body mass index (BMI), do not develop liver steatosis, whereas others with normal BMI develop intense liver fat deposition. We analyse if body fat and lean mass composition, insulin resistance and adipokine profile may help to identify patients with or without liver steatosis and its severity in treatment-naïve HCV patients. Multivariate analysis showed that only trunk fat mass and insulin resistance were independently related to liver steatosis assessed on histomorphometrical grounds and its severity.