Objective: Hepatic steatosis is a common histological feature in chronic hepatitis C (CHC), but its pathogenic mechanisms are not completely understood. We aimed to evaluate the metabolic factors associated with hepatic steatosis and fibrosis in CHC patients, and the relation between metabolic syndrome (MS) and CHC.


Patients and Methods: This study included 71 patients with CHC infection who underwent clinical, BMI, biochemical (assessment of insulin resistance, serum adiponectin, TNF-α, cholesterol and triglycerides), virological and histological assessments.


Results: Significant steatosis (>33%) was detected in 54% of the patients, while 21.12% of the patients had stage 3/4 fibrosis. Higher degree of steatosis was significantly associated with higher BMI, serum insulin, HOMA index and TNF-α (P <0.0001, P <0.0006, P< 0.0001, and P <0.01 respectively). Higher stages of fibrosis were significantly associated with higher BMI and serum triglycerides (P <0.04, P <0.02 respectively). Multivariate analysis of the metabolic factors showed that HOMA index (P <0.001) and TNF-α (P <0.03) were the factors mostly predicting higher degree of steatosis. While, BMI index (P <0.01) and serum triglycerides (P <0.03) were the factors mostly predicting higher stage of fibrosis. We also found that CHC is closely related to MS, and we recognized that older age (P<0.011), higher BMI (p<0.0001), lower serum adiponectin (P <0.0001), higher TNF-α (p<0.0001) and higher steatosis degree (p<0.04) were significantly associated with MS in these patients.

Conclusions: In patients with CHC, higher BMI, HOMA-IR, serum TNF-α and triglycerides and lower serum adiponectin were associated with HCV hepatic steatosis and metabolic syndrome, while higher BMI and serum triglycerides were associated with more advanced fibrosis stage.