Ecaterina Constanța Barbu1,2,3, Cristina Emilia Chiţu-Tișu1,2,3, Mihai Lazăr1,3, Cristina Mihaela Olariu1,3, Dan Olteanu1,4, Mihai Bojincă1,2, Adrian Octavian Abagiu3, Victoria Aramă1,3, Daniela Adriana Ion1, Ioana Anca Bădărău1
1) Carol Davila University of Medicine and Pharmacy;
2) Dr. I. Cantacuzino Clinical Hospital;
3) Prof. Dr. Matei Balş National Institute for Infectious Diseases;
4) University Emergency Hospital, Bucharest, Romania
ABSTRACT Aims: We aimed to quantify global and regional body composition changes in chronic hepatitis C (CHC) patients, compare them to healthy controls and identify possible association between body composition changes and CHC. To our knowledge, this study is the first one comparing CHC patients to controls with regard to soft tissue body composition changes.
Methods: We assessed 60 CHC patients and 60 healthy controls by Dual Energy X-Ray Absorptiometry. Soft tissue and bone body composition parameters were compared between the groups (using the Mann-Whitney test). These parameters were correlated (using Spearman’s rank correlation coefficient – rho) with independent variables (age, gender, body mass index – BMI, cigarette smoking, time since CHC diagnosis, viral load, fibrosis grade, type of treatment, time of treatment) for the entire CHC group and also for subgroups according to gender.
Results: Total fat mass, trunk fat mass and percent body fat were lower in CHC patients as compared to controls. Several risk factors were associated with the reduced fat mass: low BMI, cigarette smoking and peginterferon alpha 2a plus ribavirin treatment. Peginterferon alpha 2a and ribavirin treatment negatively correlated with lean body parameters, especially in CHC males group. Bone mineral density (BMD) was lower as compared to controls and was correlated with low BMI, cigarette smoking and peginterferon alpha 2a and ribavirin treatment.
Conclusions: Patients with CHC have an acquired type of lipodystrophy (particularly in the trunk region), and also a reduced BMD as compared with controls. A low BMI, cigarette smoking and peginterferon alpha 2a and ribavirin therapy were associatd with a low fat mass and low BMD.
Key words: body composition – chronic hepatitis C – dual energy X ray absorptiometry – lipodystrophy – osteoporosis.
Abbreviations: BMD: bone mineral density; BMI: body mass index; CHC: chronic hepatitis C; DXA: Dual Energy X ray Absorptiometry; FM: fat mass; FMR: fat mass ratio; HCADS: hepatitis C associated dysmetabolic syndrome; HCV: hepatitis C virus; HO: hepatic osteodystrophy; LS: lumbar spine; LM: lean mass; PBF: percent body fat.