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Interaction between hepatitis C virus and metabolic factors

World Journal of Gastroenterology 2014年第11期20卷 2888-2901页

作者： yasunori kawaguchi Toshihiko Mizuta Department of Internal Medicine Saga Medical SchoolSaga 849-8501Japan

Hepatitis C virus (HCV) infection disrupts the normal metabolism processes, but is also influenced by several of the host’s metabolic factors. An obvious and significantly detrimental pathophysiological feature of HCV infection is insulin resistance in hepatic and peripheral tissues. Substantial research efforts have been put forth recently to elucidate the molecular mechanism of HCV-induced insulin resistance, and several cytokines, such as tumor necrosis factor-α, have been identified as important contributors to the development of insulin resistance in the distant peripheral tissues of HCV-infected patients and animal models. The demonstrated etiologies of HCV-induced whole-body insulin resistance include oxidative stress, lipid metabolism abnormalities, hepatic steatosis and iron overload. In addition, myriad effects of this condition have been characterized, including glucose intolerance, resistance to antiviral therapy, progression of hepatic fibrosis, development of hepatocellular carcinoma, and general decrease in quality of life. Metabolic-related conditions and disorders, such as visceral obesity and diabetes mellitus, have been shown to synergistically enhance HCV-induced metabolic disturbance, and are associated with worse prognosis. Yet, the molecular interactions between HCV-induced metabolic disturbance and host-associated metabolic factors remain largely unknown. The diet and lifestyle recommendations for chronic hepatitis C are basically the same as those for obesity, diabetes, and metabolic syndrome. Specifically, patients are suggested to restrict their dietary iron intake, abstain from alcohol and tobacco, and increase their intake of green tea and coffee (to attain the beneficial effects of caffeine and polyphenols). While successful clinical management of HCV-infected patients with metabolic disorders has also been achieved with some anti-diabetic (i.e., metformin) and anti-lipid (i.e., statins) medications, it is recommended th

关键词： Hepatitis C virus Insulin resistance Diabetes Lipid metabolism abnormality Hepatic steatosis Iron overload Oxidative stress Visceral obesity

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Body mass index is associated with age-at-onset of HCV-infected hepatocellular carcinoma patients

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World Journal of Gastroenterology 2011年第7期17卷 914-921页

作者： Takumi Akiyama Toshihiko Mizuta Seiji Kawazoe Yuichiro Eguchi yasunori kawaguchi Hirokazu Takahashi Iwata Ozaki Kazuma Fujimoto Department of Internal Medicine Saga Medical School Department of Hepatology Saga Prefectural Hospital Department of Hepatology Saga Prefectural Hospital Saga 8408571 Japan

AIM: To identify factors associated with the age at onset of hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC). METHODS: Five hundred and fifty-six consecutive patients positive for HCV antibody and treatment-nafive HCC diagnosed between 1995 and 2004 were analyzed. Patients were classified into three groups according to age at HCC onset: 60 years old were lower and mean BMI values of female patients 25 kg/m2 [hazard ratio (HR), 1.8, P = 0.045], excessive alcohol consumption (HR, 2.5, P = 0.024), male sex (HR, 3.6, P = 0.002), and GGT levels > 50 IU/L (HR, 2.4, P = 0.014) were independently associated with HCC onset in patients < 60 years. Low ALT level was the only factor associated with HCC onset in patients aged ≥ 80 years. CONCLUSION: Increased BMI is associated with increased risk for early HCC development in HCV-infected patients. Achieving recommended BMI and reducing alcohol intake could help prevent hepatic carcinogenesis.

关键词： Age-at-onset Hepatocellular carcinoma Hepatitis C virus Body mass index Alcohol consumption Sex difference

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