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Phase angle is associated with advanced fibrosis in patients chronically infected with hepatitis C virus
Mariana de Souza Dorna1, Livia Alves Amaral Santos1, Fernanda Futino Gondo1
1Department of Internal Medicine, Botucatu Medical School, UNESP - Univ Estadual Paulista, Botucatu, Brazil.
Insights
Phase angle (PhA) predicts advanced liver fibrosis in hepatitis C virus (HCV) patients. A decrease in PhA significantly increases the risk of developing advanced liver fibrosis.
Area of Science:
- Hepatology
- Biomarkers
- Clinical Diagnostics
Background:
- Chronic hepatitis C virus (HCV) infection is a significant cause of liver disease.
- Advanced liver fibrosis is a critical determinant of patient prognosis and treatment decisions.
- Non-invasive markers for assessing liver fibrosis are highly sought after.
Purpose of the Study:
- To investigate the association between phase angle (PhA) and advanced liver fibrosis in patients with chronic HCV infection.
- To determine if PhA can serve as a predictor of significant liver fibrosis.
Main Methods:
- Prospective evaluation of 135 patients with chronic HCV infection.
- Bioelectrical impedance analysis (BIA) to measure PhA.
- Analysis of biochemical markers and liver biopsy data for fibrosis staging.
Main Results:
- Phase angle (PhA) was found to be a significant predictor of advanced liver fibrosis (OR: 0.227; p: 0.013).
- Lower PhA values were associated with older age, increased insulin resistance, and higher inflammation.
- Optimal PhA cut-off points for advanced fibrosis were identified as 6.43° overall, 5.94° for females, and 6.72° for males.
Conclusions:
- Phase angle (PhA) is a valuable predictor of advanced liver fibrosis in patients with chronic HCV.
- A one-degree decrease in PhA was associated with a greater than four-fold increase in the risk of advanced fibrosis.
- PhA measurement via BIA offers a potential non-invasive tool for fibrosis assessment in HCV patients.
Aims:
The objective of this study was to evaluate the association of phase angle (PhA) with advanced liver fibrosis in patients chronically infected with hepatitis C virus (HCV).
Main Methods:
One hundred sixty consecutive patients chronically infected with HCV were treated at the Hepatitis C outpatient care setting of our hospital from April 2010 to May 2011 and prospectively evaluated. Bioelectrical impedance analysis measurements were performed during the first hospital visit. Biochemical measurements and liver biopsy data were collected from the patients' medical records and included in the analysis only if they were performed within three months of the inclusion of the patient in the study.
Key Findings:
One hundred sixty consecutive patients were evaluated and 25 patients were excluded. A total of 135 patients with 49.8±11.4years old were studied. Among these patients, 60% were male and the PhA was 6.5±0.8°. Regarding the stage of fibrosis, patients with advanced fibrosis were older and had more insulin resistance and more inflammation compared with patients that had mild fibrosis. Logistic regression analysis revealed that PhA was a predictor of advanced fibrosis even when adjusted for gender, age, HOMA-IR, HDL-cholesterol and AST (OR: 0.227; CI 95%: 0.090-0.569; p: 0.013). The best PhA cut-off points associated with advanced fibrosis for the combined data, for females and for males were 6.43°, 5.94° and 6.72°, respectively.
Significance:
PhA was predictor of advanced liver fibrosis in patients chronically infected with HCV. In the sample evaluated, for each one-degree decrease in PhA, the risk of advanced fibrosis increased more than four-fold.
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