Hepatitis C Infection With Liver Steatosis Compared to Hepatitis C Infection Without Liver Steatosis: Is There a Difference in Lipid Peroxidation and Indicators of Inflammation?
Hypothesis: Patients with Hepatitis C and steatosis are more oxidatively stressed than
those without steatosis. This is associated with 1) increased liver lipid peroxides and
cytokines (TNF-alpha, TGF-beta); 2) altered unsaturated fat status (intake, tissue storage
as measured in red blood cells); 3) reduced antioxidant status.
Objectives: To assess oxidative stress and nutritional status in patients with Hepatitis C
and steatosis on liver biopsy and to compare the results to the same parameters measured in
patients with Hepatitis C and no steatosis.
Primary outcome: Liver lipid peroxides
Liver: TNF-alpha; liver pathology and immunohistochemistry for adducts of MDA, a product of
lipid peroxidation (LP), alpha-smooth muscle actin (alpha-SMA), a marker of hepatic stellate
cell activation; and transforming growth factor (TGF-beta), a profibrogenic cytokine
involved in fibrogenesis, liver fatty acid composition (substrate for lipid peroxidation).
Oxidative stress and nutrition: Plasma lipid peroxides, plasma antioxidant vitamins,
antioxidant status and power, and red blood cell fatty acid composition, 7 day food record,
Insulin resistance parameters such as blood glucose, insulin, c-peptide, HBA1c Blood lipid
profile, liver enzymes (as part of standard medical assessment) Subject demographics and
medical history will also be recorded.
Observational Model: Case-Only, Time Perspective: Cross-Sectional
Johane P Allard, MD, FRCPC
University Health Network, Toronto General Hospital
Canada: Ethics Review Committee