Chronic Hepatitis C May Cause Insulin Resistance
Hepatitis C viral genotypes 1 and 4 implicated, mechanism unknown
TUESDAY, Feb. 12 (HealthDay News) -- Insulin resistance is a common feature of chronic hepatitis C, particularly infection with hepatitis C virus genotypes 1 and 4, according to study findings published in Gastroenterology in February.
Rami Moucari, M.D., of Hopital Beaujon in Clichy, France, and colleagues investigated the prevalence of insulin resistance in 600 consecutive patients with chronic hepatitis (500 with chronic hepatitis C and 100 with chronic hepatitis B) presenting for liver biopsy. Logistic regression was used to identify factors associated with insulin resistance in non-diabetic chronic hepatitis C patients and the development of fibrosis in non-cirrhotic chronic hepatitis C patients.
Insulin resistance was present in 32.4 percent of non-diabetic chronic hepatitis C patients, compared to only 5 percent of matched controls with chronic hepatitis B. Insulin resistance was independently associated with presence of metabolic syndrome, hepatitis C virus genotypes 1 and 4, significant fibrosis, and severe steatosis. Significant fibrosis was seen on biopsy in 51.1 percent of the 454 non-cirrhotic chronic hepatitis C patients, and was associated with insulin resistance, necroinflammation and severe steatosis.
"These data suggest that insulin resistance represents not only a metabolic disorder related to obesity and adipose tissue inflammation with subsequent imbalance in the secretion of specific cytokines but also a direct viral feature," the authors write.