title: Oxidative stress is closely associated with insulin resistance in genotypes 1 and 3 chronic hepatitis C.
abstract: BACKGROUND
  Chronic hepatitis C (CHC) infection is associated with insulin resistance and with oxidative stress, but the relationship between the two has not been thoroughly examined.
  
  
  OBJECTIVE
  To evaluate the association between insulin resistance and oxidative stress in CHC patients.
  
  
  METHODS
  In 115 CHC patients (68 with genotype 1 and 47 with genotype 3), the relationship between the serum concentration of malondialdehyde (MDA), a marker of oxidative stress and insulin resistance as defined by the homeostasis model (HOMA-IR) was examined.
  
  
  RESULTS
  There was no significant difference in MDA levels between genotype 1- and genotype 3-infected subjects (12.882 vs. 12.426 ng/mL, p = 0.2). By univariate analysis, factors associated with HOMA-IR in both genotypes were oxidative stress as measured by MDA (p = 0.002), body mass index (BMI), portal activity, and fibrosis. Genotype-specific differences in HOMA-IR association were steatosis and triglycerides (TG) for genotype 1, and age and glutathione (GSH) for genotype 3. In a stepwise multiple linear regression analysis in both genotypes, MDA was a significant and independent predictor of HOMA-IR (p = 0.04). As expected, BMI and fibrosis were likewise independently correlated to HOMA-IR. In addition, MDA levels were higher (p < 0.001) and GSH levels were lower (p = 0.023) in insulin-resistant subjects compared to their insulin-sensitive counterparts.
  
  
  CONCLUSIONS
  It is concluded that in CHC, oxidative stress is an independent predictor of HOMA-IR, irrespective of virus genotype. Further studies on the role of oxidative stress in the development of insulin resistance in CHC are warranted.
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, Darcy Road Westmead, Sydney, NSW 2145, Australia.
authors.forename: Said M
authors.initials: SM
authors.lastname: Hashemi
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, Darcy Road Westmead, Sydney, NSW 2145, Australia.
authors.forename: David
authors.initials: D
authors.lastname: van der Poorten
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, Darcy Road Westmead, Sydney, NSW 2145, Australia.|Departamento de Gastroenterología, Pontificia Universidad Católica, Santiago, Chile.
authors.forename: Francisco
authors.initials: F
authors.lastname: Barrera
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, Darcy Road Westmead, Sydney, NSW 2145, Australia.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Bandara
authors.affiliation: Department of Clinical Chemistry, Prince of Wales Hospital, Sydney, Australia.
authors.forename: Ora
authors.initials: O
authors.lastname: Lux
authors.affiliation: Department of Anatomical Pathology, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Kench
authors.affiliation: Storr Liver Unit, Westmead Millennium Institute, University of Sydney at Westmead Hospital, Darcy Road Westmead, Sydney, NSW 2145, Australia. jacob.george@sydney.edu.au.
authors.forename: Jacob
authors.initials: J
authors.lastname: George
keywords: Hepatitis C; Insulin resistance; Malondialdehyde; Oxidative stress