As reported in the February 2008 issue of Gastroenterology,
French researchers examined the associations between insulin resistance, HCV
genotype, serum HCV RNA level, and liver fibrosis stage (determined by biopsy)
in a prospective cohort of 500 chronic hepatitis
C and 100 chronic hepatitis B patients.
Logistic
regression analysis was used to assess independent risk factors associated with
insulin resistance in non-diabetic chronic hepatitis C patients and significant
fibrosis in non-cirrhotic hepatitis C patients. In addition, insulin resistance
parameters were compared between chronic hepatitis
B and C patients matched for epidemiological,
metabolic, and histological characteristics.
Results
•
32% of the 462 non-diabetic hepatitis C patients had insulin resistance.
•
Insulin resistance in this group was associated with the metabolic syndrome, HCV
genotypes 1 and 4 (versus 2 and 3), significant fibrosis, and severe steatosis.
•
Insulin resistance was diagnosed in 15% of 145 hepatitis C patients without metabolic
syndrome or significant fibrosis.
•
In this subgroup, insulin resistance was associated with HCV genotypes 1 and 4,
high serum HCV RNA, and moderate-to-severe necro-inflammation.
•
Significant fibrosis was present in 51% of the 454 non-cirrhotic chronic hepatitis
C patients.
•
In this group, fibrosis was associated with male sex, age greater than 40 years,
insulin resistance, moderate-to-severe necro-inflammation, and severe steatosis.
•
Insulin resistance was less frequent in chronic hepatitis B patients than in matched
chronic hepatitis C patients (5% vs 35%, respectively; P < 0.001).
Conclusion
Based
on these findings, the researchers concluded, "Insulin resistance is a specific
feature of chronic hepatitis C, associated with genotypes 1 and 4 and high serum
HCV RNA level. Significant fibrosis is associated with insulin resistance independent
from steatosis."
Several recent studies have indicated that insulin
resistance is also associated with poorer response to interferon-based hepatitis
C treatment.
You
have type 2 diabetes if your tissues are resistant to insulin and if you lack
enough insulin to overcome this resistance. Some 90% of Americans with diabetes
have this form of the disease. It is also the most common form of diabetes worldwide.
2/29/08
Reference R
Moucari, T Asselah, D Cazals-Hatem, and others. Insulin Resistance in Chronic
Hepatitis C: Association With Genotypes 1 and 4, Serum HCV RNA Level, and Liver
Fibrosis. Gastroenterology 134(2): 416-423. February 2008.
Results
