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Obesity and Steatosis Influence Serum and Liver Inflammatory Markers in People with Chronic Hepatitis C

By Liz Highleyman

A variety of factors contribute to liver disease progression in people with chronic hepatitis C virus (HCV) infection. Evidence continues to accumulate regarding the effect of metabolic abnormalities.

As described in the July 2008 issue of Hepatology, Australian researchers conducted a study to assess whether obesity and steatosis (fat accumulation in liver cells) promote expression of inflammatory markers in patients with chronic hepatitis C.

Obesity and fatty liver are commonly observed among individuals with HCV infection and are risk factors for increased fibrosis, the authors noted as background. Furthermore, obesity is accompanied by a chronic, low-grade inflammatory response that may contribute to the pathogenesis of obesity-related co-morbidities.

The investigators measured serum protein and hepatic messenger RNA (mRNA) levels of the C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) in 171 chronic hepatitis C patients. They then assessed the relationships between these cytokines and body mass index (BMI), steatosis, and histological features of inflammation and fibrosis.

Results

• Compared with lean individuals, overweight and obese patients had increased circulating CRP (P < 0.001) and hepatic CRP (P = 0.003).

• There was a significant correlation between serum protein and hepatic CRP mRNA levels (P < 0.001).

• Obesity (P = 0.001) and steatosis (P < 0.001) were both associated with increased circulating but not hepatic IL-6.

• There was a weak correlation between serum protein and hepatic IL-6 mRNA levels (P = 0.003).

• An independent relationship was observed between hepatic TNF-alpha mRNA levels and higher total inflammatory score (P < 0.001) and fibrosis stage (P = 0.037).

• Participants with HCV genotype 3 had lower hepatic TNF-alpha mRNA levels compared to those with genotype 1 (P = 0.017), but there was no relationship between serum TNF-alpha protein and hepatic TNF-alpha mRNA levels.

Based on these findings, the study authors concluded, "In patients with chronic HCV, obesity and steatosis are associated with increased expression of selected inflammatory markers; however, circulating levels of IL-6 and TNF-alpha do not reflect hepatic expression."

"Hepatic TNF-alpha was associated with both increased inflammatory activity and hepatic fibrosis, providing support for the key role of this pro-inflammatory cytokine in liver injury in chronic HCV," they added.

School of Medicine, Southern Clinical Division, University of Queensland, Brisbane, Australia; Cancer and Population Studies, Queensland Institute of Medical Research, Brisbane, Australia; Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.

7/18/08

Reference
JR Jonsson, HD Barrie, P O'Rourke, and others. Obesity and steatosis influence serum and hepatic inflammatory markers in chronic hepatitis C. Hepatology 48(1): 80-87. July 2008. ( Abstract ):





 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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