Background & Aims
Unhealthy food intake, specifically fructose, has been associated with metabolic alterations
and with the severity of liver fibrosis in patients with non-alcoholic fatty liver
disease. In a cohort of patients with genotype 1 chronic hepatitis C (G1 CHC), we
tested the association of fructose intake with the severity of liver histology.
Methods
Anthropometric and metabolic factors, including waist circumference (WC), waist-to-hip
ratio (WHR), dorso-cervical lipohypertrophy and HOMA were assessed in 147 consecutive
biopsy-proven G1 CHC patients. Food intake, namely industrial and fruit fructose,
was investigated by a three-day structured interview and a computed database.
All biopsies were scored by an experienced pathologist for staging and grading (Scheuer
classification), and graded for steatosis, which was considered moderate-severe if
⩾20%. Features of non-alcoholic steatohepatitis (NASH) in CHC were also assessed (Bedossa
classification).
Results
Mean daily intake of total, industrial and fruit fructose was 18.0 ± 8.7 g, 6.0 ± 4.7 g, and 11.9 ± 7.2 g, respectively. Intake of industrial, not fruit fructose, was independently associated
with higher WHR (p = 0.02) and hypercaloric diet (p <0.001). CHC patients with severe liver fibrosis (⩾F3) reported a significantly higher
intake of total (20.8 ± 10.2 vs. 17.2 ± 8.1 g/day; p = 0.04) and industrial fructose (7.8 ± 6.0 vs. 5.5 ± 4.2; p = 0.01), not fruit fructose (12.9 ± 8.0 vs. 11.6 ± 7.0; p = 0.34). Multivariate logistic regression analysis showed that older age (OR 1.048,
95% CI 1.004–1.094, p = 0.03), severe necroinflammatory activity (OR 3.325, 95% CI 1.347–8.209, p = 0.009), moderate-severe steatosis (OR 2.421, 95% CI 1.017–6.415, p = 0.04), and industrial fructose intake (OR 1.147, 95% CI 1.047–1.257, p = 0.003) were independently linked to severe fibrosis. No association was found between
fructose intake and liver necroinflammatory activity, steatosis, and the features
of NASH.
Conclusions
The daily intake of industrial, not fruit fructose is a risk factor for metabolic
alterations and the severity of liver fibrosis in patients with G1 CHC.
Keywords
Abbreviations:
HCV (hepatitis C virus), G1 (genotype 1), CHC (chronic hepatitis C), WC (waist circumference), DCL (dorso-cervical lipohypertrophy), WHR (waist-to-hip ratio)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 07, 2013
Accepted:
July 15,
2013
Received in revised form:
July 8,
2013
Received:
February 6,
2013
Identification
Copyright
© 2013 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
