Ultrasound reveals atherosclerosis in hepatitis patients

Hepatitis and related syndromes may be a stronger predictor of early atherosclerosis than such classic risk factors as insulin resistance, according to Italian researchers.

Researchers, using carotid ultrasound, found high levels of early atherosclerosis in patients with nonalcoholic steatohepatitis and chronic hepatitis B and C independent of classic risk factors. Highest of all were the patients with nonalcoholic steatohepatitis, regardless of age, sex, smoking history, LDL cholesterol, or insulin resistance.

Giovanni Targher from the internal medicine division at Sacro Cuore Hospital in Negrar, Italy, and colleagues at the University Hospital of Verona studied 215 subjects. They used ultrasound to measure common carotid intima-media thickness, an index of early atherosclerosis on 60 consecutive patients with biopsy-proven nonalcoholic steatohepatitis, 60 with chronic hepatitis C, 35 with hepatitis B, and an additional 60 healthy controls of comparable age and sex. The ultrasound operator was blinded to subjects' characteristics.

The lowest carotid intima-media thickness measurements were in the controls, at an average of 0.84 mm. Measurements in patients with chronic hepatitis B averaged 0.97 mm, and measurements for patients with chronic hepatitis C averaging 1.09 mm. Highest of all were measurements in patients with nonalcoholic steatohepatitis at an average of 1.23 mm. Adjusting for age, sex, body mass index, smoking, LDL cholesterol, insulin resistance, and components of the Adult Treatment Panel III-defined metabolic syndrome had little effect on any group's measurements.

Ultrasound helped researchers conclude that nonalcoholic steatophepatitis and chronic hepatitis C and B are factors more strongly associated with early atherosclerosis than classic risk factors including insulin resistance and metabolic syndrome components.