TY - JOUR
T1 - Dietary history and physical activity and risk of advanced liver disease in veterans with chronic hepatitis C infection
AU - White, Donna L.
AU - Richardson, Peter A.
AU - Al-Saadi, Mukhtar Ahmed
AU - Fitzgerald, Stephanie J.
AU - Green, Linda
AU - Amaratunge, Chami
AU - Anand, Manvir
AU - El-Serag, Hashem B.
N1 - Funding Information:
Acknowledgments This material is based upon work supported in part by VA Clinical Research Merit Review grant H-22934 from the Department of Veteran Affairs (PI: H. B. El-Serag, MD, MPH), a Houston VA Locally Initiated Pilot grant (PI: D. White, PhD), and the Houston VA HSR&D Center of Excellence (HFP90-020). Dr. White receives partial salary support from a Career Development Award (DK081736-01) and Dr. El-Serag from an Advanced Career Development Award (DK078154-03).
PY - 2011/6
Y1 - 2011/6
N2 - Background: The role of customary diet and physical activity in development of advanced HCV-related liver disease is not well-established. Methods: We conducted a retrospective association study in 91 male veterans with PCR-confirmed chronic HCV and biopsy-determined hepatic pathology. Respondents completed the Block Food Frequency and the International Physical Activity questionnaires. We conducted three independent assessments based on hepatic pathology: fibrosis (advanced = F3-F4 vs. mild = F1-F2), inflammation (advanced = A2-A3 vs. mild = A1) and steatosis (advanced = S2-S3 vs. mild = S1). Each assessment compared estimated dietary intake and physical activity in veterans with advanced disease to that in analogous veterans with mild disease. Multivariate models adjusted for total calories, age, race/ethnicity, biopsy-to-survey lag-time, BMI, pack-years smoking, and current alcohol use. Results: Average veteran age was 52, with 48% African-American. Advanced fibrosis was more prevalent than advanced inflammation or steatosis (52.7% vs. 29.7% vs. 26.4%, respectively). The strongest multivariate association was the suggestive 14-fold significantly decreased advanced fibrosis risk with lowest dietary copper intake (OR = 0.07, 95% CI 0.01-0.60). Other suggestive associations included the 6.5-fold significantly increased advanced inflammation risk with lower vitamin E intake and 6.2-fold significantly increased advanced steatosis risk with lower riboflavin intake. The only physical activity associated with degree of hepatic pathology was a two-fold greater weekly MET-minutes walking in veterans with mild compared to advanced steatosis (P = 0.02). Conclusions: Several dietary factors and walking may be associated with risk of advanced HCV-related liver disease in male veterans. However, given our modest sample size, our findings must be considered as provisional pending verification in larger prospective studies.
AB - Background: The role of customary diet and physical activity in development of advanced HCV-related liver disease is not well-established. Methods: We conducted a retrospective association study in 91 male veterans with PCR-confirmed chronic HCV and biopsy-determined hepatic pathology. Respondents completed the Block Food Frequency and the International Physical Activity questionnaires. We conducted three independent assessments based on hepatic pathology: fibrosis (advanced = F3-F4 vs. mild = F1-F2), inflammation (advanced = A2-A3 vs. mild = A1) and steatosis (advanced = S2-S3 vs. mild = S1). Each assessment compared estimated dietary intake and physical activity in veterans with advanced disease to that in analogous veterans with mild disease. Multivariate models adjusted for total calories, age, race/ethnicity, biopsy-to-survey lag-time, BMI, pack-years smoking, and current alcohol use. Results: Average veteran age was 52, with 48% African-American. Advanced fibrosis was more prevalent than advanced inflammation or steatosis (52.7% vs. 29.7% vs. 26.4%, respectively). The strongest multivariate association was the suggestive 14-fold significantly decreased advanced fibrosis risk with lowest dietary copper intake (OR = 0.07, 95% CI 0.01-0.60). Other suggestive associations included the 6.5-fold significantly increased advanced inflammation risk with lower vitamin E intake and 6.2-fold significantly increased advanced steatosis risk with lower riboflavin intake. The only physical activity associated with degree of hepatic pathology was a two-fold greater weekly MET-minutes walking in veterans with mild compared to advanced steatosis (P = 0.02). Conclusions: Several dietary factors and walking may be associated with risk of advanced HCV-related liver disease in male veterans. However, given our modest sample size, our findings must be considered as provisional pending verification in larger prospective studies.
KW - Epidemiology
KW - Exercise
KW - Gastroenterology
KW - Infectious diseases
KW - Military personnel
KW - Nutrition assessment
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U2 - 10.1007/s10620-010-1505-x
DO - 10.1007/s10620-010-1505-x
M3 - Article
C2 - 21188525
AN - SCOPUS:79959767330
SN - 0163-2116
VL - 56
SP - 1835
EP - 1847
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 6
ER -