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Internal and Emergency Medicine

, Volume 11, Issue 4, pp 553–559 | Cite as

Renal function is impaired in normotensive chronic HCV patients: role of insulin resistance

  • Angela Sciacqua
  • Maria Perticone
  • Eliezer J. Tassone
  • Antonio Cimellaro
  • Benedetto Caroleo
  • Sofia Miceli
  • Michele Andreucci
  • Anna Licata
  • Giorgio Sesti
  • Francesco Perticone
IM - ORIGINAL

Abstract

Renal dysfunction is an independent predictor for cardiovascular morbidity and mortality. We investigated whether chronic hepatitis C virus (HCV) infection and the related insulin resistance/hyperinsulinemia influence renal function in comparison with a group of healthy subjects and with another group with metabolic syndrome. We enrolled 130 newly diagnosed HCV outpatients matched for age and gender with 130 patients with metabolic syndrome and 130 healthy subjects. Renal function was evaluated by calculation of glomerular filtration rate (e-GFR, mL/min/1.73 m2) using the CKD-EPI equation. The following laboratory parameters were measured: fasting plasma glucose and insulin, total, LDL- and HDL-cholesterol, triglyceride, creatinine, and HOMA to evaluate insulin sensitivity. HCV patients with respect to both healthy subjects and metabolic syndrome patients have a decreased e-GFR: 86.6 ± 16.1 vs 120.2 ± 23.1 mL/min/1.73 m2 (P < 0.0001) and 94.9 ± 22.6 mL/min/1.73 m2 (P = 0.003), respectively. Regarding biochemical variables, HCV patients, in comparison with healthy subjects, have a higher triglyceride level, creatinine, fasting insulin and HOMA (3.4 ± 1.4 vs 2.6 ± 1.3; P < 0.0001). At linear regression analysis, the correlation between e-GFR and HOMA is similar in the metabolic syndrome (r = −0.555, P < 0.0001) and HCV (r = −0.527, P < 0.0001) groups. At multiple regression analysis, HOMA is the major determinant of e-GFR in both groups, accounting for, respectively, 30.8 and 27.8 % of its variation in the metabolic syndrome and HCV. In conclusion, we demonstrate that HCV patients have a significant reduction of e-GFR and that insulin resistance is the major predictor of renal dysfunction.

Keywords

Chronic C hepatitis Renal function Insulin resistance Cardiovascular risk Metabolic syndrome 

Notes

Compliance with ethical standards

Funding

No relationship with any industry or financial support exists.

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Written informed consent was obtained from all participants.

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Copyright information

© SIMI 2015

Authors and Affiliations

  • Angela Sciacqua
    • 1
  • Maria Perticone
    • 2
  • Eliezer J. Tassone
    • 1
  • Antonio Cimellaro
    • 1
  • Benedetto Caroleo
    • 1
  • Sofia Miceli
    • 1
  • Michele Andreucci
    • 3
  • Anna Licata
    • 4
  • Giorgio Sesti
    • 1
  • Francesco Perticone
    • 1
  1. 1.Department of Medical and Surgical SciencesUniversity Magna Græcia of CatanzaroCatanzaroItaly
  2. 2.Department of Experimental and Clinical MedicineUniversity Magna Græcia of CatanzaroCatanzaroItaly
  3. 3.Department of Health SciencesUniversity Magna Græcia of CatanzaroCatanzaroItaly
  4. 4.Biomedical Department of Internal and Specialistic MedicineUniversity of PalermoPalermoItaly

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