title: High hepatitis C viral load is associated with insulin resistance in patients with chronic hepatitis C.
abstract: OBJECTIVE
  Although insulin resistance affects liver fibrosis progression and treatment response in chronic hepatitis C (CHC), the relationship between chronic hepatitis C virus (HCV) infection and insulin resistance (IR) remains to be firmly established. We thus studied the impact of host, metabolic and viral factors on IR in CHC patients.
  
  
  METHODS
  A total of 162 CHC patients with complete clinical data were enrolled. Among them, 94 received histological examinations. Quantitative HCV RNA was assayed by a real-time polymerase chain reaction (PCR) assay. Genotyping was performed by reverse transcription PCR with type-specific primers. The pretreatment IR index was determined using homeostasis model assessment (HOMA), and an index value of more than 2.4 was designated IR. Unadjusted and adjusted association of the HCV RNA level and IR was further analysed.
  
  
  RESULTS
  In multivariate linear regression analysis, a dose-response relationship was observed between the log(10) HCV RNA level and the presence of IR. IR was positively correlated with body mass index, triglyceride, HCV RNA and alanine aminotransferase levels, but negatively correlated with adiponectin level. Subgroup analysis stratified by HCV genotype showed that there was a trend towards a higher HOMR-IR index value and lower adiponectin levels in genotype 1 patients. Histological analysis showed that IR was positively associated with the severity of hepatic steatosis.
  
  
  CONCLUSIONS
  Our data indicate that higher HCV RNA levels are associated with the presence of IR in CHC patients. Further studies are needed to clarify the interplays between HCV infection, IR and adiponectin in an attempt to develop new adjuvant therapy for CHC.
authors.affiliation: Department of Hepatogastroenterology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Taipei Branch, Taiwan.
authors.forename: Ching-Sheng
authors.initials: CS
authors.lastname: Hsu
authors.forename: Chun-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Chen-Hua
authors.initials: CH
authors.lastname: Liu
authors.forename: Chia-Chi
authors.initials: CC
authors.lastname: Wang
authors.forename: Chi-Ling
authors.initials: CL
authors.lastname: Chen
authors.forename: Ming-Yang
authors.initials: MY
authors.lastname: Lai
authors.forename: Pei-Jer
authors.initials: PJ
authors.lastname: Chen
authors.forename: Jia-Horng
authors.initials: JH
authors.lastname: Kao
authors.forename: Ding-Shinn
authors.initials: DS
authors.lastname: Chen
mesh_terms: D000410:Alanine Transaminase / Q000378:metabolism; D015992:Body Mass Index; D005260:Female; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000473:pathology* / Q000821:virology*; D006801:Humans; D007333:Insulin Resistance / Q000235:genetics*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012367:RNA, Viral / Q000235:genetics*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014280:Triglycerides / Q000097:blood; D019562:Viral Load
chemical_list: D012367:RNA, Viral; D014280:Triglycerides; D000410:Alanine Transaminase