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Satoshi Oeda,
Toshihiko Mizuta, Hiroshi Isoda,
Takuya Kuwashiro,
Shinji Iwane,
Hirokazu Takahashi,
Yasunori Kawaguchi,
Yuichiro Eguchi,
Iwata Ozaki,
Keitaro Tanaka,
Kazuma Fujimoto
Hepato-gastroenterology 05/2013; 60(126). · 0.66 Impact Factor
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Takuya Kuwashiro,
Toshihiko Mizuta,
Yasunori Kawaguchi,
Shinji Iwane,
Hirokazu Takahashi,
Noriko Oza,
Satoshi Oeda, Hiroshi Isoda,
Yuichiro Eguchi,
Iwata Ozaki,
Keizo Anzai,
Kazuma Fujimoto
[show abstract]
[hide abstract]
ABSTRACT: BACKGROUND: Although it has been reported that hepatitis C virus (HCV) infection is associated with a significant decline in health-related quality of life (HRQOL), the underlying causes and mechanisms are still unknown. Insulin resistance (IR) is recognized as a distinct aspect of chronic HCV infection. Therefore, we attempted to identify the factors including IR indices that are related to the HRQOL of patients with chronic hepatitis C (CHC). METHODS: One hundred and seventy-five CHC patients (91 female, 84 male, mean age, 56.4 years) not using antidiabetic agents were included and underwent a 75-g oral glucose tolerance test (OGTT) and completed a self-administered HRQOL questionnaire, the Short Form 36 (SF-36), which is a well-validated questionnaire for assessing general QOL. Scale scores were standardized and summarized into physical and mental component summary (PCS and MCS). We investigated which clinical parameters, including homeostasis model assessment of insulin resistance (HOMA-IR), were associated with decline in PCS and MCS scores in CHC patients. RESULTS: There were no significant differences in clinical parameters between high and low MCS, but there were significant differences in age, sex, hemoglobin, liver fibrosis, OGTT pattern, and HOMA-IR between high and low PCS. Multivariate analysis showed that HOMA-IR >2 was independently associated with lower PCS (OR 2.92, p < 0.01). CONCLUSIONS: Our results suggest that impairment of HRQOL, especially physical domains, in CHC patients is associated with IR.
Journal of Gastroenterology 03/2013; · 4.16 Impact Factor
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Satoshi Oeda,
Toshihiko Mizuta, Hiroshi Isoda,
Takuya Kuwashiro,
Noriko Oza,
Shinji Iwane,
Hirokazu Takahashi,
Yasunori Kawaguchi,
Yuichiro Eguchi,
Shuji Toda,
Iwata Ozaki,
Keizo Anzai,
Kazuma Fujimoto
[show abstract]
[hide abstract]
ABSTRACT: The treatment strategy for cases of combined autoimmune hepatitis (AIH) and chronic hepatitis C (CHC) has not yet been established. A 47-year-old woman and a 53-year-old-woman were hospitalized for treatment of CHC. Ultrasonography and histological findings revealed that their liver was not cirrhotic but did have chronic damage. The histological findings of both patients were suggestive of AIH. The patients were systematically treated with pegylated interferon-alpha 2b plus ribavirin which was preceded by and combined with corticosteroid (CS), and showed sustained virological responses and normal liver function. Although these two patients with combined AIH and CHC were successfully treated with this regimen, careful attention to exacerbation of hepatic inflammation is needed because hepatitis C viral load was increased due to immunosuppression during CS treatment.
Clinical Journal of Gastroenterology 04/2012; 5(2):141-145.
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Hirokazu Takahashi,
Toshihiko Mizuta,
Yuichiro Eguchi,
Yasunori Kawaguchi,
Takuya Kuwashiro,
Satoshi Oeda, Hiroshi Isoda,
Noriko Oza,
Shinji Iwane,
Kenichi Izumi,
Keizou Anzai,
Iwata Ozaki,
Kazuma Fujimoto
[show abstract]
[hide abstract]
ABSTRACT: Several epidemiological studies have reported that diabetes mellitus is a risk factor for hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)-positive patients. However, it is unclear whether or not post-challenge hyperglycemia is a risk factor. The purpose of this study was to determine the association between post-challenge hyperglycemia and hepatocarcinogenesis in HCV-positive patients.
A total of 203 HCV-RNA-positive subjects (108 males, mean age 54.3 ± 10.8 years; 95 females, mean age 56.6 ± 10.3 years; genotype 1b/2a/2b/3a: 152/38/12/1) who underwent liver biopsy and a 75-g oral glucose tolerance test, and who were treated with interferon (IFN) were enrolled in this study. None of the subjects had been treated with antidiabetic drugs. The subjects underwent ultrasonography and/or computed tomography every 6 months after the end of the IFN therapy.
Thirteen patients, including one patient who achieved a sustained viral response (SVR) with IFN, developed HCC. On multivariate analysis, male sex, age >65 years, excessive alcohol consumption, non-SVR, liver steatosis area >5% in liver specimens, and 120-min post-challenge hyperglycemia were risk factors for the development of HCC. After matching subjects for sex, age, alcohol intake, and response to the IFN therapy, advanced fibrosis stages [hazard ratio (HR) 2.8], liver steatosis (HR 5.4), and 120-min post-challenge hyperglycemia (HR 4.9) were significant risk factors for the development of HCC. Furthermore, after matching for the fibrosis stage, liver steatosis (HR 5.7) and 120-min post-challenge hyperglycemia (HR 6.9) remained as significant factors for HCC development.
Post-challenge hyperglycemia is an independent risk factor for HCC in HCV-positive patients.
Journal of Gastroenterology 02/2011; 46(6):790-8. · 4.16 Impact Factor
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Yuichiro Eguchi,
Toshihiko Mizuta,
Yoshio Sumida,
Eriko Ishibashi,
Yoichiro Kitajima, Hiroshi Isoda,
Hiroko Horie,
Takaya Tashiro,
Eri Iwamoto,
Hirokazu Takahashi, [......],
Yasunori Kawaguchi,
Yasutomo Oda,
Sei Emura,
Ryuichi Iwakiri,
Iwata Ozaki,
Takahisa Eguchi,
Naofumi Ono,
Keizo Anzai,
Kazuma Fujimoto,
Shunzo Koizumi
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ABSTRACT: Our previous studies have indicated a close association between visceral fat accumulation and hepatic steatosis in nonalcoholic fatty liver disease (NAFLD). This study investigated whether visceral fat accumulation was related to the pathogenesis and disease progression of nonalcoholic steatohepatitis (NASH)/NAFLD.
First, a total of 550 subjects who underwent a health checkup and measurement of visceral fat accumulation, done with a bioelectrical impedance analyzer (X-SCAN; Owa Medical, Fukuoka, Japan), were included. The relationship between visceral fat accumulation and biochemical parameters was examined. Second, a total of 74 patients with NASH/NAFLD who underwent liver biopsy were reviewed. Visceral fat accumulation was determined by abdominal computed tomography. The association between visceral fat accumulation and the histopathological grade/stage determined by the NAFLD activity score and Brunt's classification was evaluated.
There was a significant relationship between visceral fat accumulation and glucose, triglyceride, and alanine aminotransferase (ALT; r = 0.423, P < 0.01). In stepwise regression analysis, visceral fat area (VFA), serum triglyceride level, and serum low-density lipoprotein (LDL)-cholesterol level were selected as predictor variables for serum ALT level, in a continuous manner (serum ALT level = -1.359 + 0.143 × VFA + 0.046 × triglyceride + 0.059 × LDL, R(2) = 0.217, P < 0.001). In patients with NASH, there was no correlation between histological grade and the visceral fat volume. Visceral fat accumulation in patients with stage 3/4 advanced NASH was greater than that in patients with stage 1/2 early NASH (P < 0.05).
These results suggest that visceral fat accumulation plays a role in steatosis and fibrosis in the pathogenesis and prognosis of NAFLD.
Journal of Gastroenterology 11/2010; 46 Suppl 1:70-8. · 4.16 Impact Factor
