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Reuters Health Information (2008-04-07): Adiponectin predicts steatosis and response to IFN in chronic HCV


Adiponectin predicts steatosis and response to IFN in chronic HCV

Last Updated: 2008-04-07 15:26:36 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Lower adiponectin levels are associated with a higher risk of liver steatosis and a lower rate of response to interferon (IFN)-alpha treatment in patients with chronic hepatitis C, according to a report in the March issue of the American Journal of Gastroenterology.

Recent studies have shown an association between nonalcoholic steatohepatitis (NASH) and reduced serum adiponectin, the authors explain, but the relationship between IFN-alpha treatment and serum adiponectin has not been examined in detail.

Dr. Theodoros A. Zografos and associates from University of Thessaly, Larissa, Greece evaluated whether various features of chronic hepatitis C, including the presence of steatosis and the response to treatment, could be linked to serum adiponectin and tumor necrosis factor (TNF)-alpha levels.

Among 83 patients with chronic hepatis C, those with steatosis had significantly higher TNF-alpha levels than those without steatosis, the authors report, but adiponectin levels did not differ significantly between the 2 groups.

After adjustment for hepatitic C virus (HCV) genotype, however, lower serum adiponectin and longer disease duration were independent predictors of steatosis grade in patients infected with HCV genotype 1. In patients with HCV genotype 3, lower adiponectin and increased body mass index (BMI) were independently associated with steatosis grade.

Alterations in serum adiponectin level were not associated with response to antiviral drugs, the researchers note, but patients infected with HCV genotype 3 had significantly higher serum adiponectin levels at the end of IFN-alpha therapy.

Moreover, virological responders to IFN-alpha treatment had significantly higher serum adiponectin before the beginning of therapy than did nonresponders, and lower serum adiponectin and HCV genotype 1 were the only independent variables that predicted no virological response to IFN-alpha treatment.

"This study suggests that in chronic hepatitis C patients infected with HCV genotype 3, a direct effect of the virus may result in decreased adiponectin levels," the investigators write.

"Serum adiponectin and TNF-alpha at baseline seem to be independent predictors of liver steatosis irrespective of HCV genotype, while adiponectin is also an independent predictor of the achievement of end-of-treatment virological response," they conclude.

Am J Gastroenterol 2008;103:605-614.

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