Zampino R, et al. - Chronic hepatitis C patients (CHC) were investigated for the incidence of endotoxinemia and how it impacts inflammation, liver damage, insulin resistance (IR) and atherosclerosis. Researchers found a high occurrence of among these patients. Through increased pro-inflammatory cytokines and oxidative stress, endotoxinemia contributes to the development of hepatic steatosis, IR and atherosclerosis. In these patients, anti-endotoxin treatment could have a role.

Methods

• Researchers recruited consecutive CHC patients assessed by liver biopsy.
• LAL test was used to evaluate endotoxinemia.
• Using HOMA-IR, IR was estimated.
• ELISA tests were used to determine serum TNF-α, IL-8, adiponectin and MCP-1.
• Determination of oxidative stress was performed by circulating IgG against malondialdehyde adducts with human serum albumin (MDA-HAS).
• Ultrasonography was used to assess carotid atherosclerosis.

Results

• Researchers recruited 126 patients; 60% of these showed endotoxinemia.
• Observations revealed a serum level-dependent association between endotoxinemia, steatosis (p < 0.001) and HOMA-IR (p < 0.006).
• Significantly increased TNF-α and IL8 levels were noted among patients with endotoxinemia.
• Correlation of TNF-α with steatosis (p < 0.001) and HOMA-IR (p < 0.03) was noted, however, IL8 seemed correlated with steatosis (p=<0.001), TNF-α (p< 0.04) and atherosclerosis (p < 0.01).
• The highest levels of endotoxinemia were noted to be correlated with oxidative stress and a higher prevalence of carotid atherosclerosis.
• Multivariate logistic regression analysis revaled hepatic steatosis, HOMA-IR, IL8 and MDA-HAS as independent factors associated with endotoxinemia.