Visceral adiposity index is associated with histological findings and with high viral load in patients with chronic hepatitis C due to genotype 1†

Salvatore Petta 1,*,‡, Marco Amato 2, Daniela Cabibi 3, Calogero Cammà 1, Vito Di Marco 1, Carla Giordano 2, Aldo Galluzzo 2, Antonio Craxì 1

DOI: 10.1002/hep.23859
Copyright © 2010 American Association for the Study of Liver Diseases

Author Information

1 Cattedra di Gastroenterologia, DiBiMIS, University of Palermo, Italy
2 Dipartimento di Oncologia Sperimentale ed Applicazioni Cliniche (DOSAC), Section of Endocrinology, University of Palermo, Italy
3 Cattedra di Anatomia Patologica, University of Palermo, Italy
Email: Salvatore Petta (petsa@inwind.it)

*Correspondence: Salvatore Petta, Gastroenterologia & Epatologia, Piazza delle Cliniche, 2, 90127 Palermo, Italy

†FINANCIAL SUPPORT No conflict of interest exists.

‡Ph: +39 091 655 2145; Fax +39 091 655 2156

Publication History
Accepted manuscript online: 29 JUL 2010 12:00AM EST
Manuscript Accepted: 13 JUL 2010
Manuscript Revised: 9 JUL 2010
Manuscript Received: 20 MAY 2010

Abstract

Background and Aims:
Metabolic factors have been associated with liver damage in patients with genotype 1 chronic hepatitis C (G1 CHC). We tested visceral adiposity index (VAI), a new marker of adipose dysfunction in G1 CHC patients to assess its association with host and viral factors, and its link to both histological findings and sustained virologic response (SVR).

Materials and Methods:
Two hundred thirty-six consecutive G1 CHC patients were evaluated by liver biopsy and anthropometric and metabolic measurements, including IR, the homeostasis model assessment (HOMA), and VAI by using waist circumference, body mass index, triglycerides and HDL. All biopsies were scored by one pathologist for staging and grading (Scheuer), and graded for steatosis, which was considered moderate-severe if ≥30%.

Results:
VAI score was independently associated with higher HOMA score (p=0.009), higher Log10 HCV RNA levels (p=0.01), necroinflammatory activity (p=0.04), and steatosis (p=0.04), by multiple linear regression analysis. IR (OR 3.879,95%CI 1.727–8.713, p=0.001), higher VAI score (OR 1.472,95%CI 1.051–2.062, p=0.02), and fibrosis (OR 2.255,95%CI 1.349–3.768, p=0.002) were linked to steatosis ≥30% by multiple logistic regression analysis. Older age (OR 1.030;95% CI 1.002-1.059; p=0.03), high VAI score (OR 1.618;95%CI 1.001-2.617; p=0.04) and fibrosis (OR 2.608;95%CI 1.565-4.345; p<0.001) were independently associated with moderate-severe necroinflammatory activity by logistic regression analysis. No independent associations were found between VAI score and both fibrosis and SVR.

Conclusion:
In G1 CHC patients, higher VAI score, a new index of adipose dysfunction, is independently associated with both steatosis and necroinflammatory activity, and has a direct correlation with viral load. (HEPATOLOGY 2010.)

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