New Data Suggest that Patients with Chronic Liver Disease are at Increased Risk
for Heart Disease By
Liz Highleyman
Past
studies have produced conflicting data regarding the prevalence of cardiovascular
disease risk factors -- including insulin resistance and elevated blood lipids
-- in people with hepatitis C.
As reported
in the June 2007 Journal of Hepatology, Italian researchers conducted a
study to analyze carotid intima-media thickness (IMT) in patients with 3 forms
of chronic liver disease:
Increased
carotid IMT -- a measure of the health of the carotid arteries in the neck --
is an indicator of early atherosclerosis, or "hardening of the arteries."
The
investigators studied 60 consecutive patients with biopsy-proven NASH, 60 with
HCV, 35 with HBV, and 60 healthy control subjects of comparable age and sex. Common
carotid IMT was measured using ultrasonography.
Results
•
Carotid IMT measurements were markedly different among the groups:
- lowest
in healthy controls (0.84); - intermediate in patients with HBV or HCV (0.97
and 1.09, respectively); - highest in those with NASH (1.23) (P < 0.001).
• These differences
among the groups were minimally affected by adjustment for age, sex, body mass
index, smoking, low-density lipoprotein (LDL, or "bad") cholesterol
levels, insulin resistance, and components of metabolic syndrome (as defined by
the Adult Treatment Panel III).
•
In a logistic regression analysis, NASH, HBV, and HCV all predicted increased
carotid IMT, independent of potential confounders.
Conclusion
In
conclusion, the authors wrote, "These data suggest that NASH, HCV, and HBV
are strongly associated with early atherosclerosis independent of classical risk
factors, insulin resistance, and metabolic syndrome components."
06/29/07
Reference G Targher, L Bertolini, R Padovani, and others. Differences and similarities
in early atherosclerosis between patients with non-alcoholic steatohepatitis and
chronic hepatitis B and C. Journal of Hepatology 46(6): 1126-1132. June
2007.
