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Endotoxinemia contributes to steatosis, insulin resistance and atherosclerosis in chronic hepatitis C: The role of pro-inflammatory cytokines and oxidative stress

Infection Aug 05, 2018

Zampino R, et al. - Chronic hepatitis C patients (CHC) were investigated for the incidence of endotoxinemia and how it impacts inflammation, liver damage, insulin resistance (IR) and atherosclerosis. Researchers found a high occurrence of among these patients. Through increased pro-inflammatory cytokines and oxidative stress, endotoxinemia contributes to the development of hepatic steatosis, IR and atherosclerosis. In these patients, anti-endotoxin treatment could have a role.

Methods

  • Researchers recruited consecutive CHC patients assessed by liver biopsy.
  • LAL test was used to evaluate endotoxinemia.
  • Using HOMA-IR, IR was estimated.
  • ELISA tests were used to determine serum TNF-α, IL-8, adiponectin and MCP-1.
  • Determination of oxidative stress was performed by circulating IgG against malondialdehyde adducts with human serum albumin (MDA-HAS).
  • Ultrasonography was used to assess carotid atherosclerosis.

Results

  • Researchers recruited 126 patients; 60% of these showed endotoxinemia.
  • Observations revealed a serum level-dependent association between endotoxinemia, steatosis (p < 0.001) and HOMA-IR (p < 0.006).
  • Significantly increased TNF-α and IL8 levels were noted among patients with endotoxinemia.
  • Correlation of TNF-α with steatosis (p < 0.001) and HOMA-IR (p < 0.03) was noted, however, IL8 seemed correlated with steatosis (p=<0.001), TNF-α (p< 0.04) and atherosclerosis (p < 0.01).
  • The highest levels of endotoxinemia were noted to be correlated with oxidative stress and a higher prevalence of carotid atherosclerosis.
  • Multivariate logistic regression analysis revaled hepatic steatosis, HOMA-IR, IL8 and MDA-HAS as independent factors associated with endotoxinemia.
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