Association of visceral obesity with high viral load and histological findings in elderly patients with genotype 1 chronic hepatitis C.

OBJECTIVE Genotype 1 chronic hepatitis C (G1CHC) is generally accompanied by metabolic disturbances related to visceral obesity, such as insulin resistance, steatosis, or dyslipidemia. Because these abnormalities negatively influence the clinical course of G1CHC, we sought to clarify the effect of visceral obesity on the pathophysiology of G1CHC. METHODS We evaluated 180G1CHC patients for the presence of visceral obesity on the basis of computed tomography findings. Multivariate analysis was performed to estimate the relationship between visceral obesity and demographic, viral, and biochemical characteristics of patients. The associations of visceral obesity with histological findings and serum adipokine levels were also analyzed. RESULTS Multiple logistic regression analysis revealed that visceral obesity was independently associated with metabolic syndrome, platelet count, high-density lipoprotein level, and serum viral load in elderly patients (≥65 years). Multiple linear regression analysis confirmed the association between visceral obesity and high viral load. However, visceral obesity was not correlated with viral load in non-elderly patients (<65 years). Histological data (160 patients) demonstrated the significant association between visceral obesity and steatosis. Furthermore, patients with visceral obesity showed increase in the severity of fibrosis with advancing age. However, age-associated fibrosis progression was not evident in patients without visceral obesity. The serum adiponectin level was significantly low in patients with visceral obesity, whereas those of leptin, tumor necrosis factor-α, and interleukin-6 were not affected significantly. CONCLUSION Visceral obesity was associated with high viral load and histological damage in elderly patients with reduced adiponectin levels.