Hepatic steatosis and insulin resistance are associated with serum imbalance of adiponectin/tumour necrosis factor‐α in chronic hepatitis C patients

• Published in: Alimentary pharmacology & therapeutics Vol. 24; no. 9; pp. 1349 - 1357
• Main Authors: DURANTE‐MANGONI, E., ZAMPINO, R., MARRONE, A., TRIPODI, M.‐F., RINALDI, L., RESTIVO, L., CIOFFI, M., RUGGIERO, G., ADINOLFI, L. E.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-11-2006; Blackwell
• Subjects: Adiponectin - metabolism; Adolescent; Adult; Aged; Biological and medical sciences; Blood Glucose - metabolism; Digestive system; Fatty Liver - blood; Fatty Liver - etiology; Female; Gastroenterology. Liver. Pancreas. Abdomen; Genotype; Hepatitis C, Chronic - blood; Hepatitis C, Chronic - complications; Human viral diseases; Humans; Infectious diseases; Insulin Resistance - physiology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Pharmacology. Drug treatments; Tumor Necrosis Factor-alpha - metabolism; Viral diseases; Viral hepatitis; Endocrinopathy; Human; Biological fluid; Pancreatic hormone; Cytokine; Hepatic disease; Patient; Insulin; Adiponectin; Infection; Target tissue resistance; Fatty liver; Viral disease; Digestive diseases; Insulin resistance; Serum; Tumor necrosis factor α; Viral hepatitis C
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/j.1365-2036.2006.03114.x

Summary
Background
Steatosis and insulin resistance (IR) have a pathogenic role in chronic hepatitis C (HCV). Adipocytokines balance modulates hepatic lipid content and IR.
Aim
To evaluate serum adipocytokines and relationship with virological, histological and metabolic parameters in chronic HCV.
Methods
Adiponectin and tumour necrosis factor‐α (TNF‐α) levels, HCV genotypes, HCV‐RNA, IR (HOMA‐IR), body mass index and liver steatosis and fibrosis were assessed in 161 non‐diabetic chronic HCV patients.
Results
Chronic HCV patients with steatosis showed lower serum adiponectin levels and higher levels of TNF‐α, HOMA, alanine aminotransferase, γ‐glutamiltransferase and Histological Activity Index (HAI) and fibrosis scores. Low adiponectin levels were independently associated with grades of steatosis and HOMA‐IR. Higher tumour necrosis factor‐α levels were observed in patients with low adiponectin levels. The extension of steatosis was inversely correlated with adiponectin levels. A correlation between grade of steatosis with HOMA‐IR and fibrosis was observed. HCV genotype 3‐infected patients showed lower adiponectin levels than those with other genotypes. An independent predictor of low adiponectin levels in genotype 3 infection was the extension of steatosis. Liver fibrosis score was associated with steatosis, HAI and age.
Conclusions
Chronic HCV patients with steatosis showed a serum adiponectin/TNF‐α imbalance that is associated with IR. Reduced adiponectin levels may be involved in the pathogenesis of steatosis, which in turn accelerates progression of fibrosis in chronic HCV.