More advanced hepatic fibrosis in hispanics with chronic hepatitis C infection: Role of patient demographics, hepatic necroinflammation, and steatosis

被引:46
|
作者
Verma, Sumita
Bonacini, Maurizio
Govindarajan, Sugantba
Kanel, Gary
Lindsay, Karen L.
Redeker, Allan
机构
[1] Hepatitis Res & Treatment Ctr, Div Gastrointestinal & Liver Dis, Los Angeles, CA USA
[2] Calif Pacific Med Ctr, Dept Transplantat, San Francisco, CA USA
[3] Rancho Los Amigos Med Ctr, Downey, CA USA
[4] Univ So Calif, Dept Pathol, Los Angeles, CA 90089 USA
来源
AMERICAN JOURNAL OF GASTROENTEROLOGY | 2006年 / 101卷 / 08期
关键词
D O I
10.1111/j.1572-0241.2006.00682.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND AND AIMS:We sought to assess whether Hispanics have more advanced hepatitis C virus (HCV)-related liver disease than non-Hispanic whites (NHW) and to identify contributory factors. PATIENTS AND METHODS: Patients were recruited from the Los Angeles county hepatitis clinic. Liver fibrosis and necroinflammation (NI) were assessed by the Ishak scoring system. Hepatic steatosis was graded as 0-4. RESULTS: A total of 232 patients were evaluated, 63 NHW and 169 Hispanic. Hispanics were older and had a higher prevalence of blood transfusion (40% vs 21%), obesity (body mass index > 30) (47% Vs 21%), diabetes mellitus (DM) (16% vs 5%), and hepatic steatosis (79% vs 47%), p < 0.02. Independent predictors of hepatic steatosis were Hispanic ethnicity (odds ratio [OR] 3.8, 95% Cl 1.7-8.7, p = 0.001) and obesity (OR 5.7, 95% Cl 2.3-14.1, p = 0.0002). Compared with NHW, Hispanics also had higher fibrosis stage (3.3 +/- 2 vs 2.3 +/- 6.9, p = 0.001), NI grade (6.4 +/- 1.8 Vs 5.6 +/- 1.6, p = 0.002), and faster fibrosis progression/yr (0.14 +/- 0.09 vs 0.09 +/- 0.07, p = 0.0002). Presence of DM (OR 2.9, p = 0.02), grade 1-2 hepatic steatosis (OR 2.3, p = 0.03), AST/ALT > I (OR 4.3, p = 0.01), NI grade (OR 1.7, p < 0.0001), age at biopsy (OR 1.1, p < 0.0001), and serum bilirubin (OR 5.4, p < 0.0001) were independent predictors of fibrosis stage > 4. CONCLUSION: This study confirms that Hispanics have more advanced hepatic fibrosis than NHW. This is related to older age, higher NI grade, and greater prevalence of hepatic steatosis and DM.
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页码:1817 / 1823
页数:7
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