Adiponectin Level Predicts Liver Steatosis and Response to Interferon-based Tre

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Adiponectin Level Predicts Liver Steatosis and Response to

Interferon-based Treatment for Chronic Hepatitis C

A growing body of research underlines the role of metabolic

abnormalities in people with chronic hepatitis C virus (HCV).

As reported in the March 2008 American Journal of Gastroenterology,

Greek researchers performed a study with the following objectives:

• To compare serum adiponectin and tumor necrosis factor (TNF)-alpha

levels among patients with viral liver diseases.

• To investigate associations of serum adiponectin and TNF-alpha with

histological or viral characteristics in patients with chronic

hepatitis C;

• To investigate adiponectin and TNF-alpha alterations during

interferon alpha treatment;

• To assess the relationship between serum adiponectin and TNF-alpha

and response rates to treatment.

Adiponectin is a hormone produces by adipose tissue (fat cells) that

plays a role in regulating processing of glucose and fatty acids. A

low level is associated with various metabolic abnormalities.

The study included 83 chronic hepatitis C patients, 59 chronic

hepatitis B patients, and 43 blood donors who served as healthy,

uninfected controls. Participants with hepatitis B were treated with

4.5 MU thrice-weekly interferon alpha for 12 months. Those with

hepatitis C received 3 MU thrice-weekly interferon alpha plus

ribavirin for 6 or 12 months, depending on HCV genotype. Adiponectin

and TNF-alpha levels were measured before, at the middle point, at

the end, and 6 months after completion of treatment.

Results

• After adjusting for sex and body mass index (BMI), overweight

patients (BMI > 25 kg/m2) with HCV genotype 3 had significantly lower

adiponectin levels at baseline (median 7.3 mcg/mL) than overweight

patients with other genotypes (P < 0.05).

• Lower adiponectin (P= 0.02 for genotype 3, P= 0.025 for genotype 1)

and higher TNF-alpha levels (P= 0.025) at baseline were independent

predictors of liver steatosis in hepatitis C patients.

• Lower adiponectin was an independent predictor of lack of

virological response at the end of interferon/ribavirin treatment (OR

0.76; P < 0.001).

• At the end of therapy, only HCV genotype 3 patients had

significantly higher serum adiponectin (10.4 mcg/mL) compared with

the pre-treatment level (8.7 mcg/mL; P < 0.05).

Conclusion

" This study suggests that HCV genotype 3 may directly affect

adiponectin, " the researchers concluded. " This is further supported

by the significant increase in adiponectin at the end of treatment

only in HCV genotype 3 patients. "

They added that, " Serum adiponectin at baseline appears to be an

independent predictor of liver steatosis and for the achievement of

end-of-treatment virological response, while serum TNF-alpha at

baseline was identified as an independent predictor only of liver

steatosis. "

3/21/08