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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Hépato-Gastroentérologie, Hôpital Saint-Pierre, Université Libre de Bruxelles, Bruxelles, Belgium. thomas.serste@skynet.be
Thomas
T
Sersté
Marcel
M
Nkuize
Rami
R
Moucari
Marc
M
Van Gossum
Marijke
M
Reynders
Robert
R
Scheen
Françoise
F
Vertongen
Michel
M
Buset
Jean Pierre
JP
Mulkay
Patrick
P
Marcellin
D000328:Adult; D000704:Analysis of Variance; D018912:Arabs; D001530:Belgium / Q000453:epidemiology; D044383:Black People; D001794:Blood Pressure; D015992:Body Mass Index; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000235:genetics; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology* / Q000208:ethnology* / Q000209:etiology; D008875:Middle Aged; D044465:White People