Hepatitis C virus infection enhances insulin resistance induced by visceral fat accumulation

Liver Int. 2009 Feb;29(2):213-20. doi: 10.1111/j.1478-3231.2008.01853.x. Epub 2008 Aug 14.

Abstract

Background/aims: To clarify the impact of visceral obesity on hepatitis C virus (HCV)-infected patients, we examined the relationship between insulin resistance development and visceral fat accumulation.

Methods: We analyzed 87 HCV-infected patients with mild fibrosis (stage 1 or 2) in comparison with 125 sex- and age-matched patients with non-alcoholic fatty liver disease (NAFLD). The degree of visceral fat area (VFA; cm(2)) at the umbilical level was measured by abdominal computed tomography and divided into two grades: no visceral obesity, VFA<100 and visceral obesity, VFA>/=100. Insulin resistance was evaluated by homeostasis model assessment of insulin resistance (HOMA-IR) and the quantitative insulin sensitivity check index (QUICKI). Pancreatic beta-cell function was evaluated by homeostasis model assessment of beta-cell function (HOMA-beta). Serum soluble tumour necrosis factor (TNF)-receptors 1 and 2 and adiponectin were measured.

Results: Insulin resistance evaluated by HOMA-IR and QUICKI was correlated with visceral fat accumulation, and was higher in HCV patients than in NAFLD patients with visceral obesity. HOMA-beta was higher in HCV patients than in NAFLD patients for each VFA grade. Serum-soluble TNF-receptors 1 and 2 were higher in HCV patients than in NAFLD patients with visceral obesity.

Conclusions: Hepatitis C virus infection is a risk factor for development of insulin resistance, particularly in patients with visceral obesity.

MeSH terms

  • Adiponectin / blood
  • Blood Chemical Analysis
  • Fatty Liver / physiopathology*
  • Female
  • Hepatitis C / physiopathology*
  • Humans
  • Insulin Resistance / physiology*
  • Intra-Abdominal Fat / physiopathology*
  • Japan
  • Liver / pathology
  • Male
  • Models, Biological
  • Obesity / physiopathology*
  • Receptors, Tumor Necrosis Factor / blood
  • Statistics, Nonparametric

Substances

  • Adiponectin
  • Receptors, Tumor Necrosis Factor