title: Depression is not associated with peripheral insulin resistance in patients with chronic hepatitis C infection.
abstract: Depression is common in individuals infected with hepatitis C virus (HCV), and both depression and HCV infection are independently associated with insulin resistance (IR). To evaluate the relationship between depression and IR, among other factors, in an HCV-infected cohort. In this cross-sectional analysis, seventy-four non-type 2 diabetic, noncirrhotic, HCV-infected patients underwent comprehensive clinical, histologic and metabolic evaluation. IR was assessed directly with an insulin suppression test by measuring steady-state plasma glucose (SSPG) levels during continuous infusions of octreotide, glucose and insulin. Logistic regression modelling was used to evaluate predictors associated with depression. Thirty-nine (53%) patients were depressed, and 21 (54%) depressed patients were on at least one antidepressant. A higher estimated proportion of depressed patients were Caucasian (51% vs 20%, P = 0.005), unemployed (69% vs 49%, P = 0.07), heavier smokers (18 pack-years vs 13 pack-years, P = 0.07), on substance abuse therapy (16% vs 3%, P = 0.06) and had lower HDL levels (1.2 mmol/L vs 1.4 mmol/L, P = 0.01). The mean SSPG levels in depressed and nondepressed patients were 7.3 and 8.3 mmol/L (P = 0.45), respectively. In multipredictor adjusted analysis, only Caucasian race (OR 4.19, 95% CI 1.42-12.35, P = 0.009) and lower HDL (OR 0.95, 95% CI 0.89-0.99, P = 0.046) were associated with depression. In conclusion, although prevalent, depression was not associated with peripheral IR in this HCV-infected cohort. Attention to other modifiable factors associated with depression in the HCV-infected population is warranted.
authors.affiliation: Department of Medicine, San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA.
authors.forename: S C
authors.initials: SC
authors.lastname: Shah
authors.forename: J
authors.initials: J
authors.lastname: Kornak
authors.forename: M
authors.initials: M
authors.lastname: Khalili
mesh_terms: D000328:Adult; D001786:Blood Glucose; D015331:Cohort Studies; D003863:Depression / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005838:Genotype; D005947:Glucose / Q000378:metabolism; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D005947:Glucose
keywords: clamp studies; hepatitis C; impaired fasting glucose; impaired glucose tolerance; insulin resistance; neuropsychiatric