The Liver, Liver Disease, and Diabetes Mellitus

Albright, Eric S.; Bell, David S.H.

doi:10.1097/00019616-200301000-00011

Cited by 16 publications

(7 citation statements)

References 65 publications

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“…Hepatitis C viral (HCV) infection has been suspected to affect glucose metabolism and predispose HCV‐infected individuals to insulin resistance (IR) and type 2 diabetes diabetes mellitus (DM) [1,2]. Although not entirely clear, the proposed mechanisms for HCV‐related IR/DM may include direct pancreatic β‐cell destruction, autoimmune β‐cell injury and other mechanisms [3–6]. To support these hypotheses, one study has linked HCV core protein levels with IR as measured by increasing HOMA score values and decreasing the expression of insulin receptor substrate (IRS)‐1 and IRS‐2 [7].…”

Section: Introductionmentioning

confidence: 99%

Association of hepatitis C with insulin resistance and type 2 diabetes in US general population: the impact of the epidemic of obesity

Stepanova

Lam

Younossi

et al. 2011

Journal of Viral Hepatitis

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Studies from tertiary care medical centres have linked hepatitis C virus (HCV) to the development of insulin resistance (IR) and type 2 diabetes. The aim of the study is to assess the relationship between HCV positivity and insulin resistance/diabetes in the US population. Three cycles of the National Health and Nutrition Examination Survey (NHANES) conducted between 1988 and 2008 were used. HCV infection was diagnosed using a positive serologic anti-HCV test. Additionally, diabetes was diagnosed as fasting blood glucose ≥126 mg/dL and/or the use of hypoglycaemic medications. Insulin resistance was defined as a homeostasis of model assessment (HOMA) score of >3.0. Logistic regression was used to estimate the odds ratios (ORs) of each of the potential risk factors for diabetes mellitus (DM). The SUDAAN 10.0 was used to run descriptive and regression analyses. A total of 39 506 individuals from three NHANES cycles (1988-1994, 1999-2004 and 2005-2008) with complete demographic and relevant clinical data were included. Over these three NHANES cycles, prevalence of hepatitis C did not significantly change. During the first NHANES cycle (1988-1994), insulin and diabetes were independently associated with hepatitis C. However, during the later study cycles (1998-2008), these associations were no longer significant. In contrast, other important known risk factors for diabetes and IR (male gender, non-Caucasian race, age and obesity) remained significant over all three NHANES cycles. Although HCV infection was independently associated with an increased risk of diabetes and IR in the US population over a decade ago, assessment of the later NHANES cycles shows that this relationship may have become diluted by the rapid rise of other risks for diabetes, specifically, the prevalence of obesity.

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Section: Introductionmentioning

confidence: 99%

Association of hepatitis C with insulin resistance and type 2 diabetes in US general population: the impact of the epidemic of obesity

Stepanova

Lam

Younossi

et al. 2011

Journal of Viral Hepatitis

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“…Reduction in HOMA‐IR during treatment may have been the result of the weight loss observed across the entire cohort during treatment, although this was significant compared with pretreatment in the SVR group only. Proposed mechanisms of IR have included direct beta cell destruction, autoimmune beta cell injury and the presence of NAFLD . Other studies have demonstrated it to be a direct viral feature linking HCV core protein levels with HOMA‐IR and a decrease in the expression of insulin receptor substrates 1 and 2 …”

Section: Discussionmentioning

confidence: 99%

“…Proposed mechanisms of IR have included direct beta cell destruction, autoimmune beta cell injury and the presence of NAFLD. 25,26 Other studies have demonstrated it to be a direct viral feature 23 linking HCV core protein levels with HOMA-IR and a decrease in the expression of insulin receptor substrates 1 and 2. 27 To our knowledge, only four studies 24,28-30 have demonstrated improvement in HOMA-IR post-viral clearance, with another study demonstrating improvement in HOMA-B but not HOMA-IR.…”

Section: Clinicopathological Features Associated With Fibrosismentioning

confidence: 99%

Sustained virological response following chronic hepatitis C treatment is associated with improvement in insulin resistance

Chan

Hansen

Gilliver

et al. 2013

Internal Medicine Journal

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“…Postulated mechanisms by which CHC infection causes IR and possibly DM are many and appear to include hepatic FFA accumulation, direct viral effects on insulin signaling, and chronic inflammatory processes in hepatic and adipose tissue [23][24][25][26][27][28]. Chronic inflammation plays a significant role in the development of IR in metabolic liver disease because of increased levels of proinflammatory cytokines such as interleukin (IL)-1, tumor necrosis factor (TNF)-α, IL-6, and leptin, as well as decreased levels of adiponectin [11].…”

Section: Mechanisms Of Ir In Hcvmentioning

confidence: 99%

Metabolic Syndrome and HCV: Where Do We Stand in 2010?

Lamb

Harrison

2010

Curr Hepatitis Rep

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Hepatitis C virus (HCV) infection and metabolic syndrome are common worldwide. Insulin resistance, an inherent part of metabolic syndrome, may result from HCV infection and has been shown to affect outcomes for chronic hepatitis C (CHC) virus infection. Various host and virally mediated factors contribute to insulin resistance and ultimately the metabolic syndrome. The metabolic derangements in combination with CHC virus affect disease natural history and treatment outcomes. The ideal treatment strategy for patients with features of metabolic syndrome and CHC virus infection is unknown, but most would agree to treat the components of the metabolic syndrome.

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The Liver, Liver Disease, and Diabetes Mellitus

Cited by 16 publications

References 65 publications

Association of hepatitis C with insulin resistance and type 2 diabetes in US general population: the impact of the epidemic of obesity

Association of hepatitis C with insulin resistance and type 2 diabetes in US general population: the impact of the epidemic of obesity

Sustained virological response following chronic hepatitis C treatment is associated with improvement in insulin resistance

Metabolic Syndrome and HCV: Where Do We Stand in 2010?

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