Original Article

Authors: L. Mateva¹, K. Antonov¹, D. Jelev¹, A. Alexiev¹, A. Ivanova¹, R. Ivanova², D. Kioseva², A. Gegova^2
1Clinic of Gastroenterology,
² Laboratory of Clinical Pathology, University Hospital “St. Ivan Rilski”, Sofia, Bulgaria

Address for correspondence: L. Mateva - Clinic of Gastroenterology, University Hospital “St.Ivan Rilski”, 15 Acad. Ivan Geshov Blvd, 1431 Sofia, Bulgaria, tel/fax: +359 2 9523481, e-mail: lucymateva@yahoo.com

 

Keywords: hepatic steatosis, metabolic syndrome, insulin resistance, diabetes mellitus, chronic hepatitis C

 

Abstract

The relationship between metabolic steatosis and HCV infection has been studied widely. We performed a retrospective and prospective evaluation of the frequency of steatosis and the components of metabolic syndrome/insulin resistance and their impact on the severity and stage of chronic hepatitis C in 366 patients. Liver steatosis was found in 62% and metabolic syndrome in 50.5% of the patients. In cases without steatosis, there was not more than one of the components of metabolic syndrome. Impaired fasting glucose (IFG) and diabetes (p<0.01), as well as impaired glucose tolerance (IGT) and diabetes during oral glucose tolerance test (OGTT) (n=100, р<0.001), were observed mostly in the patients with steatosis. Insulin levels and HOMA – IR were also higher in the presence of steatosis (p=0.001). We found a relationship between the presence of steatosis and: patient’s age, components of the metabolic syndrome, insulin levels and GGT levels (p<0.001).
A positive correlation was found between the presence and degree of steatosis and steatohepatitis on the one side, and activity grading and fibrosis staging on the other (p<0.05). Hyperglycaemia (p<0.001) and the degree of hyperinsulinaemia/insulin resistance, but not the parameters of metabolic syndrome, also showed a positive correlation with the stage of fibrosis.
In conclusion, our results over a large number of patients with a chronic hepatitis C, show high frequency of liver steatosis and relationship with insulin resistance and hyperglycaemia. All these factors are related with a higher activity grade and advanced liver fibrosis. Their adequate diagnosis and treatment could benefit a better prognosis of chronic hepatitis C.