Insulin Resistance is Common in Patients with Predominantly Genotype 3 Chronic Hepatitis C

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 2009 Jun 11

PMID 19513842

Citations 7

Authors

Ajay Duseja

R K Dhiman

Yogesh Chawla

Kiran K Thumburu

Amit Kumar

Ashim Das

Sanjay Bhadada

Anil Bhansali

Affiliations

Soon will be listed here.

Abstract

Hepatitis C virus (HCV) infection has been associated with insulin resistance or diabetes mellitus, but data are controversial on the role of different HCV genotypes in causing insulin resistance. We have designed a study aimed at determining insulin resistance in patients with chronic hepatitis C with predominant genotype 3. Insulin resistance was measured using a homeostasis model of assessment for insulin resistance in 85 non-diabetic, non-cirrhotic patients with chronic hepatitis C (genotype 3 = 54). The results were compared with 38 biopsy-proven patients with non-alcoholic fatty liver disease and 25 age- and body mass index-matched healthy volunteers. Patients with chronic hepatitis C had a higher fasting insulin and homeostasis model of assessment for insulin resistance values than healthy volunteers (P = 0.0001). A large number of patients with chronic hepatitis C showed evidence of insulin resistance than healthy controls [53 (62.3%) vs. 4 (16%), respectively] (P < 0.0001). Of the various risk factors studied for insulin resistance in patients with chronic hepatitis C, higher waist (P = 0.010) and higher serum triglycerides (P = 0.002) were found to correlate with HOMA-insulin resistance. There was no difference in insulin resistance amongst patients with genotype 1 or 3, respectively. Based on these results, we conclude that insulin resistance is common among non-diabetic, non-cirrhotic patients with chronic hepatitis C. A majority of these patients had genotype 3, but there was no difference in insulin resistance between genotype 1 and genotype 3 patients.

Citing Articles

Diabetes mellitus, insulin resistance and hepatitis C virus infection: A contemporary review.

Desbois A, Cacoub P World J Gastroenterol. 2017; 23(9):1697-1711.

PMID: 28321170 PMC: 5340821. DOI: 10.3748/wjg.v23.i9.1697.

Hepatitis C virus genotype 3: Meta-analysis on sustained virologic response rates with currently available treatment options.

Ampuero J, Reddy K, Romero-Gomez M World J Gastroenterol. 2016; 22(22):5285-92.

PMID: 27298572 PMC: 4893476. DOI: 10.3748/wjg.v22.i22.5285.

Changes in circulating lipids level over time after acquiring HCV infection: results from ERCHIVES.

Butt A, Yan P, Simon T, Chung R, Abou-Samra A BMC Infect Dis. 2015; 15:510.

PMID: 26558512 PMC: 4642733. DOI: 10.1186/s12879-015-1268-2.

Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part II: INASL Recommendations for Management of HCV in India.

Puri P, Anand A, Saraswat V, Acharya S, Sarin S, Dhiman R J Clin Exp Hepatol. 2015; 4(2):117-40.

PMID: 25755549 PMC: 4116713. DOI: 10.1016/j.jceh.2014.06.001.

Insulin resistance in non-diabetic patients of chronic Hepatitis C.

Kiran Z, Zuberi B, Anis D, Qadeer R, Hassan K, Afsar S Pak J Med Sci. 2013; 29(1):201-4.

PMID: 24353540 PMC: 3809205. DOI: 10.12669/pjms.291.2888.

References

Hui J, Sud A, Farrell G, Bandara P, Byth K, Kench J . Insulin resistance is associated with chronic hepatitis C virus infection and fibrosis progression [corrected]. Gastroenterology. 2004; 125(6):1695-704. DOI: 10.1053/j.gastro.2003.08.032. View

Mason A, Lau J, Hoang N, Qian K, Alexander G, Xu L . Association of diabetes mellitus and chronic hepatitis C virus infection. Hepatology. 1999; 29(2):328-33. DOI: 10.1002/hep.510290235. View

Goodman Z, Ishak K . Histopathology of hepatitis C virus infection. Semin Liver Dis. 1995; 15(1):70-81. DOI: 10.1055/s-2007-1007264. View

Fartoux L, Poujol-Robert A, Guechot J, Wendum D, Poupon R, Serfaty L . Insulin resistance is a cause of steatosis and fibrosis progression in chronic hepatitis C. Gut. 2005; 54(7):1003-8. PMC: 1774632. DOI: 10.1136/gut.2004.050302. View

ISHAK K, Baptista A, Bianchi L, Callea F, De Groote J, Gudat F . Histological grading and staging of chronic hepatitis. J Hepatol. 1995; 22(6):696-9. DOI: 10.1016/0168-8278(95)80226-6. View

Dhiman R, Duseja A, Chawla Y . Asians need different criteria for defining overweight and obesity. Arch Intern Med. 2005; 165(9):1069-70. DOI: 10.1001/archinte.165.9.1069-b. View

Cua I, Hui J, Kench J, George J . Genotype-specific interactions of insulin resistance, steatosis, and fibrosis in chronic hepatitis C. Hepatology. 2008; 48(3):723-31. DOI: 10.1002/hep.22392. View

Kumar D, Farrell G, Fung C, George J . Hepatitis C virus genotype 3 is cytopathic to hepatocytes: Reversal of hepatic steatosis after sustained therapeutic response. Hepatology. 2002; 36(5):1266-72. DOI: 10.1053/jhep.2002.36370. View

Brunt E, Janney C, Di Bisceglie A, Neuschwander-Tetri B, Bacon B . Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol. 1999; 94(9):2467-74. DOI: 10.1111/j.1572-0241.1999.01377.x. View

10.

Kim J, Fillmore J, Chen Y, Yu C, Moore I, Pypaert M . Tissue-specific overexpression of lipoprotein lipase causes tissue-specific insulin resistance. Proc Natl Acad Sci U S A. 2001; 98(13):7522-7. PMC: 34701. DOI: 10.1073/pnas.121164498. View

11.

Grimbert S, Valensi P, Levy-Marchal C, Perret G, Richardet J, Raffoux C . High prevalence of diabetes mellitus in patients with chronic hepatitis C. A case-control study. Gastroenterol Clin Biol. 1996; 20(6-7):544-8. View

12.

Matthews D, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28(7):412-9. DOI: 10.1007/BF00280883. View

13.

FRASER G, Harman I, Meller N, Niv Y, Porath A . Diabetes mellitus is associated with chronic hepatitis C but not chronic hepatitis B infection. Isr J Med Sci. 1996; 32(7):526-30. View

14.

Allison M, Wreghitt T, Palmer C, Alexander G . Evidence for a link between hepatitis C virus infection and diabetes mellitus in a cirrhotic population. J Hepatol. 1994; 21(6):1135-9. DOI: 10.1016/s0168-8278(05)80631-2. View

15.

Duseja A, Thumburu K, Das A, Dhiman R, Chawla Y, Bhadada S . Insulin tolerance test is comparable to homeostasis model assessment for insulin resistance in patients with nonalcoholic fatty liver disease. Indian J Gastroenterol. 2007; 26(4):170-3. View

16.

Duseja A, Murlidharan R, Bhansali A, Sharma S, Das A, Das R . Assessment of insulin resistance and effect of metformin in nonalcoholic steatohepatitis--a preliminary report. Indian J Gastroenterol. 2004; 23(1):12-5. View

17.

Duseja A, Das A, Das R, Dhiman R, Chawla Y, Bhansali A . The clinicopathological profile of Indian patients with nonalcoholic fatty liver disease (NAFLD) is different from that in the West. Dig Dis Sci. 2007; 52(9):2368-74. DOI: 10.1007/s10620-006-9136-y. View

18.

Weinman S, Belalcazar L . Hepatitis C: a metabolic liver disease. Gastroenterology. 2004; 126(3):917-9. DOI: 10.1053/j.gastro.2003.01.001. View