S1332 Assessment of Risk Factors of Hepatic Steatosis Diagnosed by Vibration Controlled Transient Elastography (VCTE) in Chronic Hepatitis C Virus Infected Patients

Abstract

Introduction: In chronic hepatitis C patients, the prevalence of steatosis ranges from 40% to 86%. Our aim was to study the risk factors of moderate/severe hepatic steatosis diagnosed by vibration-controlled transient elastography (VCTE) in these patients. Methods: This retrospective cross-sectional study included a cohort of 158 adult patients with suspected nonalcoholic fatty liver disease (NAFLD) evaluated in the clinic. Patients with significant alcohol consumption, oral contraceptive use, hepatitis B, autoimmune hepatitis, and primary biliary cirrhosis were excluded. Steatosis was categorized as S0-S1 (mild) and S2-S3 (moderate/severe) based on the controlled attenuation parameter (CAP) grade. Continuous variables were assessed using an unpaired t-test and categorical variables using chi-Square with p< 0.05 were considered statistically significant. A multinominal logistic regression analysis was done to study the relationship between the CAP grade (dependent variable) and significant covariates (independent variables) while controlling for the effect of each other. The model fitting criteria used was -2 log-likelihood (LL) which was tested for goodness-of-fit and pseudo R2 showed a Negelkerke value of 0.520. Results: 136 patients met inclusion criteria. A moderate/severe steatosis score was associated with various risk factors: obesity (p< 0.05), DM (p< 0.014), metformin use (p< 0.0017), fibrosis (p< 0.009). A 4x2 chi-square Table showed 40% of patients with hepatitis C, 68% with hepatitis C + DM, 68% with DM, and 61% non-hepatitis C, non-DM patients (p-0.028) had moderate to severe hepatic steatosis. On regression analysis, the -2 LL of the reduced model in patients with hepatitis C and hepatitis C + DM revealed that omitting the effect of obesity resulted in zero degrees of freedom (df 0). Obesity had a significant association with steatosis (chi-square value 52, df 12). DM had a weak association with steatosis (chi-square value 0.825, df 3). (Figure) Conclusion: Hepatic steatosis is independently associated with metabolic parameters like obesity and DM. The chi-square analysis initially indicated that hepatitis C is associated with steatosis, but using multivariate analysis, we accounted for potential confounders, i.e., the most significant risk factor for steatosis in untreated hepatitis C patients is their BMI. Thus, the management of obesity in patients with chronic hepatitis C may be necessary for reducing the risk of steatosis progression and improving their fibrosis score.Figure 1.: Results of patient characteristics and multivariate regression analysis