title: Associations of chronic hepatitis C with metabolic and cardiac outcomes.
abstract: BACKGROUND
  Chronic hepatitis C virus (CH-C) infection is associated with metabolic conditions such as insulin resistance and type 2 diabetes (DM) and may increase the risk of cardiovascular diseases.
  
  
  OBJECTIVE
  To assess the association of CH-C with risk factors for cardiovascular diseases using US population data.
  
  
  METHODS
  The National Health and Nutrition Examination Surveys (NHANES) collected between 1999 and 2010 were used.
  
  
  RESULTS
  Of 19 741 participants considered eligible for the study. Of this cohort, 173 individuals (0.88%) had detectable HCV RNA and were considered to have CH-C. Compared with controls, CH-C patients were predominantly African American (23.5% vs. 10.5%, P < 0.0001), men (66.6% vs. 46.1%, P = 0.0001), more likely to be between 45 and 55 years of age (41.9% vs. 20.4%, P = 0.0001), had higher rate of insulin resistance (44.1% vs. 31.1%, P = 0.0301), hypertension (40.1% vs. 28.9%, P = 0.0201), and history of smoking (76.2% vs. 29.9%, P < 0.0001). In multivariate analysis, in addition to known risk factors for insulin resistance, CH-C was independently associated with the presence of insulin resistance [OR (95% CI) = 2.06 (1.19-3.57)], DM [OR = 2.31 (1.18-4.54)] and hypertension [OR = 2.06 (1.30-3.24)]. Independent predictors of cardiovascular diseases included older age, presence of obesity and smoking. CH-C was independently associated with congestive heart failure subtype of cardiovascular diseases but not ischaemic heart disease and stroke.
  
  
  CONCLUSIONS
  Chronic hepatitis C virus infection is independently associated with presence of metabolic conditions (insulin resistance, type 2 diabetes mellitus and hypertension) and congestive heart failure.
authors: Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, USA. zobair.younossi@inova.org
authors: Z M
authors: ZM
authors: Younossi
authors: M
authors: M
authors: Stepanova
authors: F
authors: F
authors: Nader
authors: Z
authors: Z
authors: Younossi
authors: E
authors: E
authors: Elsheikh
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006630:Hispanic or Latino; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D044465:White People