Insulin sensitivity and variability in hepatitis C virus infection using direct measurement

Nizar A Mukhtar, Peter Bacchetti, Claudia E Ayala, Jennifer Melgar, Spencer Christensen, Jacquelyn J Maher, Mandana Khalili, Nizar A Mukhtar, Peter Bacchetti, Claudia E Ayala, Jennifer Melgar, Spencer Christensen, Jacquelyn J Maher, Mandana Khalili

Abstract

Background and aims: Studies investigating insulin resistance (IR) in chronic hepatitis C virus (HCV) infection have used surrogate measures of IR that have limited reliability. We aimed to describe the distribution and risk factors associated with IR and its change over time in HCV using direct measurement.

Methods: One hundred two non-cirrhotic, non-diabetic, HCV-infected subjects underwent clinical, histologic, and metabolic evaluation, and 27 completed repeat evaluation at 6 months. Insulin-mediated glucose uptake was measured by steady-state plasma glucose (SSPG) concentration during the insulin suppression test.

Results: Three subjects with diabetes were excluded and 95 completed all testing. SSPG ranged from 39 to 328 mg/dL (mean 135 mg/dL) and was stable over time (mean SSPG change -0.3 mg/dL). SSPG was associated with Latino ethnicity (Coef 67, 95 % CI 37-96), BMI (Coef 19 per 5 kg/m(2), 95 % CI 5-32), ferritin (Coef 1.4 per 10 ng/ml, 95 % CI 0.2-2.5), male gender (Coef -48, 95 % CI -80 to -16), and HDL (Coef -16, 95 % CI -28 to -5 mg/dL). Current tobacco use (Coef 55, 95 % CI 19-90), steatosis (Coef -44, 95 % CI -86 to -3), and increases in BMI (Coef 30 per 5 kg/m(2), 95 % CI 6-53) and triglyceride (Coef 3.5 per 10 mg/dL, 95 % CI 0.3-6.7) predicted change in SSPG.

Conclusions: There was a wide spectrum of insulin resistance in our HCV population. Host factors, rather than viral factors, appeared to more greatly influence insulin action and its change in HCV.

Figures

Figure 1. Distribution of Insulin Resistance (SSPG)…
Figure 1. Distribution of Insulin Resistance (SSPG) Among HCV Subjects
Histogram depicts the proportion of subjects at each designated SSPG interval. Twenty-five percent of HCV-infected subjects had a SSPG greater than 180mg/dl.
Figure 2. Change in SSPG Levels Over…
Figure 2. Change in SSPG Levels Over Time
Line plots depict changes in SSPG level over 6 months follow-up for each of 27 HCV-infected subjects.

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Source: PubMed

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