High prevalence of insulin resistance among Brazilian chronic hepatitis C patients

Abstract

Objective: This study aims to estimate the prevalence of insulin resistance (IR) among chronic hepatitis C (CHC) patients and their related laboratory and demographic data. Subjects and methods: In this study, non-diabetic CHC patients referred to Viral Hepatitis Ambulatories from Rio de Janeiro (Brazil) donated blood samples. Insulin was measured using a chemiluminescence immunoassay. IR was determined by HOMA-IR, where HOMA-IR > 2 was defined as IR. Results: A total of 214 CHC patients were recruited (123 females aged 53.6 years ± 10.9 years). IR was present in 133 patients (62.1%) and was associated in bivariate analysis to higher mean values of age (p = 0.040), triglycerides (p = 0.032), glucose (p = 0.000), insulin (p = 0.000), waist circumference (p = 0.001), and body mass index (p = 0.007); however, none of these variables were significant in the multivariate analysis. Conclusions: The high prevalence of IR was observed among CHC patients, and there was no difference in clinical or laboratory parameters when both groups were compared in the multivariate analysis. This high IR prevalence could lead to a high risk for development of cardiovascular disease and metabolic disorders. Arch Endocrinol Metab. 2017;61(6):628-32

Hepatitis C virus infection in chronic kidney disease: paradigm shift in management

“…Various hepatic and/or extrahepatic manifestations of HCV infection can contribute to renal deterioration. Insulin resistance is associated with HCV-induced hepatic dysfunction and has been found in 10% to 60% of HCV-infected patients [ 16 - 18 ]. However, recent experimental studies have demonstrated that the HCV core protein interferes with insulin signaling by degrading insulin receptor substrate-1 by upregulating the expression of mammalian target of rapamycin (mTOR)/p70 ribosomal protein S6 kinase 1, suppressor of cytokine signaling 3, and tumor necrosis factor-α [ 19 , 20 ]; and downregulating glucose transporter 2,4 expression through upregulation of glucose-6-phosphatase and phosphoenolpyruvate carboxykinase 2 [ 21 , 22 ].…”

Influência de polimorfismos no gene MTTP nos níveis de lipídeos e na esteatose associada à infecção crônica pelo vírus da hepatite C

“…Além disso, a resistência à insulina está associada a um risco aumentado de desenvolver pré-diabetes e, possivelmente, diabetes mellitus tipo 2 (Alzahrani, 2022), doença cardiovascular e renal em pacientes com hepatite C crônica (Fabrizi;Donato;Messa, 2017). No presente estudo foi observada uma prevalência de 34% de resistência à insulina entre os portadores crônicos do HCV, e essa prevalência foi menor do que a descrita por Villar et al (2017). Esse estudo encontrou uma prevalência de 62% de resistência à insulina em 214 participantes com hepatite C crônica atendidos em um hospital no Rio de Janeiro (Villar et al, 2017), porém, nesse estudo foi utilizado um valor de corte menor para resistência à insulina (HOMA-IR > 2) quando comparado ao presente estudo (HOMA-IR ≥ 3).…”

“…No presente estudo foi observada uma prevalência de 34% de resistência à insulina entre os portadores crônicos do HCV, e essa prevalência foi menor do que a descrita por Villar et al (2017). Esse estudo encontrou uma prevalência de 62% de resistência à insulina em 214 participantes com hepatite C crônica atendidos em um hospital no Rio de Janeiro (Villar et al, 2017), porém, nesse estudo foi utilizado um valor de corte menor para resistência à insulina (HOMA-IR > 2) quando comparado ao presente estudo (HOMA-IR ≥ 3).…”