Serum apolipoprotein C-III is independently associated with chronic hepatitis C infection and advanced fibrosis

J. Rowell; A. J. Thompson; J. R. Guyton; X. Q. Lao; J. G. McHutchison; J. J. McCarthy; K. Patel

doi:10.1007/s12072-011-9291-x

Serum apolipoprotein C-III is independently associated with chronic hepatitis C infection and advanced fibrosis

J. Rowell, A. J. Thompson, J. R. Guyton, X. Q. Lao, J. G. McHutchison, J. J. McCarthy, K. Patel^*

^*Corresponding author for this work

Research output: Journal Publications and Reviews › RGC 21 - Publication in refereed journal › peer-review

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Abstract

Background The hepatitis C virus (HCV) is known to disrupt lipid metabolism, making serum lipoprotein levels good candidates to explore as markers of HCV disease progression. Assessment of the major apolipoproteins (Apo) and their relationship to hepatic fibrosis remain largely unexplored.

Methods We compared the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), and Apo A-I, -B, -C-III, and -E between patients with cleared versus active infection (n = 83), and between those chronically infected patients (n = 216) with advanced versus mild-moderate hepatic fibrosis (METAVIR stage F3-4 vs. F0-2) using multiple logistic regression.

Results Apo C-III levels were 25% higher in subjects with cleared infection versus those with active infection (p = 0.009). Low levels of Apo C-III (p = 1.3 × 10 ^-5), Apo A-I (p = 2.9 × 10 ^-5), total cholesterol (p = 5.0 × 10 ^-4), LDL-C (p = 0.005), and HDL-C (p = 2.0 × 10 ^-4) were associated with advanced fibrosis in univariate analyses. Multivariable analysis revealed Apo C-III as the most significant factor associated with advanced fibrosis (p = 0.0004), followed by age (p = 0.013) and Apo A-I (p = 0.022). Inclusion of both Apo C-III and Apo A-I in a model to predict advanced fibrosis improved the area under the receiver operator curve only modestly.

Conclusions Relative to other lipoproteins, low serum Apo C-III levels are the most strongly associated with chronic versus cleared infection and decline with increasing severity of hepatic fibrosis. Apo C-III deserves further attention as a possible marker of HCV disease progression. © Asian Pacific Association for the Study of the Liver 2011.

Original language	English
Pages (from-to)	475-481
Journal	Hepatology International
Volume	6
Issue number	2
Online published	7 Jul 2011
DOIs	https://doi.org/10.1007/s12072-011-9291-x
Publication status	Published - Apr 2012
Externally published	Yes

Funding

This study was funded in large part by a generous grant from the David H Murdock Institute for Business and Culture via the M.U.R.D.O.C.K. Study and NIH CTSA award 1 UL1 RR024128-01. Dr. Rowell is supported by NIH Training Grant T32-DK007012-31 at Duke University Medical Center. Dr. Thompson received funding support from the Duke Clinical Research Institute, a generous research gift from the Richard B. Boebel Family Fund, the National Health and Medical Research Council of Australia, and the Gastroenterology Society of Australia.

Research Keywords

Apolipoprotein AI
Apolipoprotein C-III
Fibrosis
Hepatitis C virus

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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title = "Serum apolipoprotein C-III is independently associated with chronic hepatitis C infection and advanced fibrosis",

abstract = "Background The hepatitis C virus (HCV) is known to disrupt lipid metabolism, making serum lipoprotein levels good candidates to explore as markers of HCV disease progression. Assessment of the major apolipoproteins (Apo) and their relationship to hepatic fibrosis remain largely unexplored. Methods We compared the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), and Apo A-I, -B, -C-III, and -E between patients with cleared versus active infection (n = 83), and between those chronically infected patients (n = 216) with advanced versus mild-moderate hepatic fibrosis (METAVIR stage F3-4 vs. F0-2) using multiple logistic regression. Results Apo C-III levels were 25% higher in subjects with cleared infection versus those with active infection (p = 0.009). Low levels of Apo C-III (p = 1.3 × 10 -5), Apo A-I (p = 2.9 × 10 -5), total cholesterol (p = 5.0 × 10 -4), LDL-C (p = 0.005), and HDL-C (p = 2.0 × 10 -4) were associated with advanced fibrosis in univariate analyses. Multivariable analysis revealed Apo C-III as the most significant factor associated with advanced fibrosis (p = 0.0004), followed by age (p = 0.013) and Apo A-I (p = 0.022). Inclusion of both Apo C-III and Apo A-I in a model to predict advanced fibrosis improved the area under the receiver operator curve only modestly. Conclusions Relative to other lipoproteins, low serum Apo C-III levels are the most strongly associated with chronic versus cleared infection and decline with increasing severity of hepatic fibrosis. Apo C-III deserves further attention as a possible marker of HCV disease progression. {\textcopyright} Asian Pacific Association for the Study of the Liver 2011.",

keywords = "Apolipoprotein AI, Apolipoprotein C-III, Fibrosis, Hepatitis C virus",

author = "J. Rowell and Thompson, {A. J.} and Guyton, {J. R.} and Lao, {X. Q.} and McHutchison, {J. G.} and McCarthy, {J. J.} and K. Patel",

year = "2012",

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doi = "10.1007/s12072-011-9291-x",

language = "English",

volume = "6",

pages = "475--481",

journal = "Hepatology International",

issn = "1936-0533",

publisher = "Springer",

number = "2",

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TY - JOUR

T1 - Serum apolipoprotein C-III is independently associated with chronic hepatitis C infection and advanced fibrosis

AU - Rowell, J.

AU - Thompson, A. J.

AU - Guyton, J. R.

AU - Lao, X. Q.

AU - McHutchison, J. G.

AU - McCarthy, J. J.

AU - Patel, K.

PY - 2012/4

Y1 - 2012/4

N2 - Background The hepatitis C virus (HCV) is known to disrupt lipid metabolism, making serum lipoprotein levels good candidates to explore as markers of HCV disease progression. Assessment of the major apolipoproteins (Apo) and their relationship to hepatic fibrosis remain largely unexplored. Methods We compared the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), and Apo A-I, -B, -C-III, and -E between patients with cleared versus active infection (n = 83), and between those chronically infected patients (n = 216) with advanced versus mild-moderate hepatic fibrosis (METAVIR stage F3-4 vs. F0-2) using multiple logistic regression. Results Apo C-III levels were 25% higher in subjects with cleared infection versus those with active infection (p = 0.009). Low levels of Apo C-III (p = 1.3 × 10 -5), Apo A-I (p = 2.9 × 10 -5), total cholesterol (p = 5.0 × 10 -4), LDL-C (p = 0.005), and HDL-C (p = 2.0 × 10 -4) were associated with advanced fibrosis in univariate analyses. Multivariable analysis revealed Apo C-III as the most significant factor associated with advanced fibrosis (p = 0.0004), followed by age (p = 0.013) and Apo A-I (p = 0.022). Inclusion of both Apo C-III and Apo A-I in a model to predict advanced fibrosis improved the area under the receiver operator curve only modestly. Conclusions Relative to other lipoproteins, low serum Apo C-III levels are the most strongly associated with chronic versus cleared infection and decline with increasing severity of hepatic fibrosis. Apo C-III deserves further attention as a possible marker of HCV disease progression. © Asian Pacific Association for the Study of the Liver 2011.

AB - Background The hepatitis C virus (HCV) is known to disrupt lipid metabolism, making serum lipoprotein levels good candidates to explore as markers of HCV disease progression. Assessment of the major apolipoproteins (Apo) and their relationship to hepatic fibrosis remain largely unexplored. Methods We compared the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), and Apo A-I, -B, -C-III, and -E between patients with cleared versus active infection (n = 83), and between those chronically infected patients (n = 216) with advanced versus mild-moderate hepatic fibrosis (METAVIR stage F3-4 vs. F0-2) using multiple logistic regression. Results Apo C-III levels were 25% higher in subjects with cleared infection versus those with active infection (p = 0.009). Low levels of Apo C-III (p = 1.3 × 10 -5), Apo A-I (p = 2.9 × 10 -5), total cholesterol (p = 5.0 × 10 -4), LDL-C (p = 0.005), and HDL-C (p = 2.0 × 10 -4) were associated with advanced fibrosis in univariate analyses. Multivariable analysis revealed Apo C-III as the most significant factor associated with advanced fibrosis (p = 0.0004), followed by age (p = 0.013) and Apo A-I (p = 0.022). Inclusion of both Apo C-III and Apo A-I in a model to predict advanced fibrosis improved the area under the receiver operator curve only modestly. Conclusions Relative to other lipoproteins, low serum Apo C-III levels are the most strongly associated with chronic versus cleared infection and decline with increasing severity of hepatic fibrosis. Apo C-III deserves further attention as a possible marker of HCV disease progression. © Asian Pacific Association for the Study of the Liver 2011.

KW - Apolipoprotein AI

KW - Apolipoprotein C-III

KW - Fibrosis

KW - Hepatitis C virus

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U2 - 10.1007/s12072-011-9291-x

DO - 10.1007/s12072-011-9291-x

M3 - RGC 21 - Publication in refereed journal

AN - SCOPUS:84862897538

SN - 1936-0533

VL - 6

SP - 475

EP - 481

JO - Hepatology International

JF - Hepatology International

IS - 2

ER -

Serum apolipoprotein C-III is independently associated with chronic hepatitis C infection and advanced fibrosis

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