Metabolic disorders associated with chronic hepatitis C: impact of genotype and ethnicity

Hépato-Gastroentérologie, Hôpital Saint-Pierre, Université Libre de Bruxelles, Bruxelles, Belgium.
Liver international: official journal of the International Association for the Study of the Liver (Impact Factor: 4.85). 09/2010; 30(8):1131-6. DOI: 10.1111/j.1478-3231.2010.02291.x
Source: PubMed


Patients with hepatitis C virus (HCV) infection, especially those with genotypes 1 and 4, have an increased risk of developing metabolic disorders. The aim of this study was to evaluate the associations among metabolic disorders, ethnicity and genotype in a large cohort of patients with chronic hepatitis C (CHC).
All consecutive patients with CHC who were seen in our hepato-gastroenterology unit between January 2002 and September 2008 were included. Demographical data and variables related to the metabolic syndrome were collected. Insulin resistance was assessed using the homeostasis model for the assessment of insulin resistance test (HOMA-IR) test.
Among the 454 CHC patients, the prevalence of the metabolic syndrome was 12.4%. The HOMA-IR test was performed in 140 patients, and 35.0% had insulin resistance. There were more Black Africans among the patients with genotypes 1/4 than among those with genotypes 2/3 (32.0 vs 1.2%, P<0.0001). Insulin resistance was more common in patients with genotypes 1/4 than in those with genotypes 2/3 (17 vs 1.7%, P=0.0001 and 43.3 vs 16.3%, P=0.001, respectively). Genotypes 1/4 were more frequently present in patients with insulin resistance than in those without insulin resistance (85.7 vs 60.5%, P=0.001). By logistic regression, genotypes 1/4 [odds ratio (OR)=2.79; 95% confidence interval (CI): 1.09-7.12, P=0.032] and older age (OR=1.03; 95% CI: 1.004-1.06, P=0.024) were independently associated with the presence of insulin resistance.
In CHC, insulin resistance is independently associated with the presence of genotypes 1/4. Ethnicity is not independently associated with metabolic disorders in patients with CHC.

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    • "The prevalence of the MS in patients with CHC varied from 4.4% in Italy, 24.7% in Taiwan and 51% in US veterans (Huang et al., 2009a; Keane et al., 2009; Svegliati-Baroni et al., 2007), suggesting that host factors such as ethnic origin could play a role in the association between IR and CHC (Conjeevaram et al., 2007; Serste et al., 2010). Liangpunsakul et al examined the relationship between nondiabetic subjects with HCV infection and microalbuminuria by using NHANES III database which consisted of 15,336 adults from the United States. "

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