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 chronic HCV infection who underwent clinical, BMI, biochemical (assessment of insulin resistance, serum adiponectin, TNF-α, cholesterol and triglycerides), virological and histological assessments.


Results: Of 71 patients with CHC. 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 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 BMI and serum triglycerides (P <0.04; P <0.02 respectively). Multivariate analysis of the metabolic factors shows that HOMA index (P <0.001) and TNF-α (P <0.03) are the factors mostly predicting higher degree of steatosis. While, BMI index (P <0.01) and serum triglycerides (P <0.03) are the factors mostly predicting higher stage of fibrosis. We also found that CHC is closely related to MS, and we recognized that age (P<0.011), BMI (p<0.0001), serum adiponectin (0.0001), TNF-α (p<0.0001) and steatosis degree (p<0.04) are significantly associated with MS in these patients.

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