Background Despite the negative impact of low muscle mass (MM) on the survival of cirrhotic patients, the mechanisms linked to MM loss are not completely understood in patients with chronic hepatitis C (CHC).
Objectives To evaluate whether the IL-10 haplotype (-1082G>A, -819C>T, and -592C>A) and serum levels of tumour necrosis factor-alpha (TNF-α) were associated with low MM in CHC patients.
Methods 94 consecutive CHC outpatients (mean age, 50.3±11.5 yrs.; 74.5% males; 68.1% without cirrhosis and 31.9% with compensated cirrhosis) and 164 healthy controls were prospectively enrolled. SNPs were genotyped by RT-PCR. Serum levels of TNF-α were measured by ELISA. CHC patients, prospectively, underwent scanning of the lean tissue, appendicular skeletal muscle mass (ASM), and fat mass by dual-energy X-ray absorptiometry. The data analysed included appendicular skeletal mass (ASM) standardized for height (ASMI=ASM/height2). The cut-off points for low ASMI were 5.45 kg/m2 and 7.26 kg/m2 for women and men, respectively, according to Baumgartner et al. (1998). The International Physical Activity Questionnaire was used to determine the physical activity level.
Results IL-10 SNPs were in Hardy Weinberg equilibrium. Patients and healthy subjects showed the same distribution of genotypes. Low ASMI was found in 12/94 (12.8%) of the patients with CHC. The IL-10 haplotype ATA (low-producer genotype) was observed in 11/12 (91.7%) of the patients with low ASMI (P=0.03) and in only one of the patients without low ASMI 1/82 (1.2%) (Figure 1). In the multivariate analysis, low ASMI was significantly and independently associated with moderate-to-high physical activity (OR=0.31; 95%CI=0.09-0.98; P=0.05), TNF-α levels (OR=1.06; 95%CI=1.01-1.11; P=0.02) and ATA haplotype (OR=9.87; 95%CI=1.13-94.85; P=0.05).
Conclusion This is the first study to demonstrate that the IL10 haplotype is associated with low ASMI in CHC patients. We also demonstrated that TNF-α is associated with low ASMI in CHC patients.
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