Predictive Value of the Fibrosis Scores in Patients with Chronic Hepatitis C Associated with Liver Fibrosis and Metabolic Syndrome
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概要
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Objective We evaluated patients with chronic hepatitis C (CHC) and compared the clinical and pathological features of steatosis and metabolic syndrome to identify the risk factors for CHC with severe fibrosis. Methods One hundred seventy-one patients with biopsy-confirmed CHC were included in the study: 90 males and 81 females, age 56.2±12.8 years; 46 with obesity (BMI≥25 kg/m2); 51 with hypertension; 36 with type 2 diabetes mellitus; and 20 with hypertriglyceridemia. Results Steatosis was detected in 79 patients (46%); 92 patients (54%) showed no steatosis. Seventy-four patients (43%) showed mild fibrosis and 97 patients (56%) showed severe fibrosis. The variables that were significantly associated with steatosis were obesity [odds ratio 2.160 (1.010-4.727), p=0.046] and type 2 diabetes [odds ratio 3.667 (1.559-8.430), p=0.027]. The variables that were significantly associated with severe fibrosis were older age [odds ratio 2.675 (1.309-5.464), p=0.007], obesity [odds ratio 2.156 (1.006-4.619), p=0.048] and type 2 diabetes [odds ratio 8.739 (2.845-26.846), p=0.0002]. Nagasaki (N) score (the total number of specific risk factors, namely an older age, obesity, and type 2 diabetes) was higher in the severe fibrosis group than in the mild fibrosis group (mild fibrosis: severe fibrosis=1.48±1.14 vs.2.66±94, p<0.001). Conclusion Metabolic syndrome factors, including obesity and diabetes, play a critical role in the pathogenesis of fibrosis in CHC. The N score was therefore found to be a significant predictor of severe fibrosis in CHC.
著者
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Isomoto Hajime
Department Of Endoscopy Nagasaki University Hospital
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MIUMA Satoshi
Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki Univ
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NAKAO Kazuhiko
Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki Univ
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Miyaaki Hisamitsu
Department Of Gastroenterology And Hepatology Graduate School Of Biomedical Sciences Nagasaki Univer
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Takeshima Fuminao
Department Of Gastroenterology And Hepatology Graduate School Of Biomedical Sciences Nagasaki Univer
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Ichikawa Tatsuki
Department Of Gastroenterology And Hepatology Graduate School Of Biomedical Sciences Nagasaki Univer
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TAURA Naota
Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences, Nagasaki University
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Shibata Hidetaka
Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Taura Naota
Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Miuma Satoshi
Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Japan
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