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Nutrition and Disease

Hepatic Fatty Acid Composition Differs between Chronic Hepatitis C Patients with and without Steatosis^1,2,3

⁴ University Health Network, Department of Medicine, Toronto, M5G 2C4 Ontario, Canada ⁵ Women and HIV Research Program, Women's College Research Institute, Toronto, M5G 1N8 Ontario, Canada ⁶ University of Toronto, Department of Nutrition, Toronto, M5S 3E2 Ontario, Canada ⁷ University of Guelph, College of Biological Science, Guelph, N1G 2W1 Ontario, Canada

Hepatic fatty acid (FA) composition may influence steatosis development in patients with chronic hepatitis C (CHC). In a cross-sectional study, we compared the hepatic FA profile in hepatitis C patients with (n = 9) and without (n = 33) steatosis (5% of hepatocytes involved). FA composition of hepatic and RBC total lipids was measured by gas chromatography. Lipid peroxidation and antioxidants in liver and plasma, blood biochemistry, and nutritional status were also assessed. Patients with steatosis had more fibrosis, higher necroinflammatory activity of their hepatitis C infection, were more often infected with genotype 3, and had lower serum cholesterol. Monounsaturated FA in the liver were higher and trans FA were lower in patients with steatosis. Lower stearic acid and higher oleic acid in hepatic total lipids suggested higher 9-desaturase activity. -Linolenic acid in the liver was higher and the ratios of long-chain PUFA:essential FA precursors were lower for (n-3) and (n-6) PUFA. Plasma vitamin C was lower in steatosis, but RBC FA composition and other parameters did not differ. We conclude that hepatic FA composition is altered in patients with hepatitis C and steatosis, probably due to modulation of enzymatic elongation and desaturation. Oxidative stress or nutritional status does not seem to play a predominant role for development of steatosis in CHC.

^* To whom correspondence should be addressed. E-mail: johane.allard{at}uhn.on.ca.

Manuscript received 31 October 2008. Initial review completed 17 November 2008. Revision accepted 7 January 2009.