Hepatology International

, Volume 7, Issue 2, pp 516–523 | Cite as

Oxidative stress is closely associated with insulin resistance in genotypes 1 and 3 chronic hepatitis C

  • Said M. Hashemi
  • David van der Poorten
  • Francisco Barrera
  • Priyanka Bandara
  • Ora Lux
  • James Kench
  • Jacob GeorgeEmail author
Original Article



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.


To evaluate the association between insulin resistance and oxidative stress in CHC patients.


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.


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.


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.


Hepatitis C Insulin resistance Malondialdehyde Oxidative stress 



Chronic hepatitis C






Homeostasis model assessment of insulin resistance


Body mass index


Waist/hip ratio


Insulin resistance


Hepatocellular carcinoma


Hepatitis C virus


Insulin resistance


Reactive oxygen species


Alanine aminotransferase


Aspartate aminotransferase


Gamma-glutamyl transpeptidase


Total cholesterol


High density lipoprotein cholesterol


Low density lipoprotein cholesterol




Human immunodeficiency virus


High performance liquid chromatography


Standard deviation






Non-structural protein 3


Non-structural protein 5A


Suppressor of cytokine signaling-3


Nuclear factor-κβ


Tumor necrosis factor-α


Conflict of interest

The authors had financial support from Robert W. Storr Bequest to the Sydney Medical Foundation and National Health and Medical Research Council (NHMRC). The authors have no conflict of interest to disclose.


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Copyright information

© Asian Pacific Association for the Study of the Liver 2012

Authors and Affiliations

  • Said M. Hashemi
    • 1
  • David van der Poorten
    • 1
  • Francisco Barrera
    • 1
    • 2
  • Priyanka Bandara
    • 1
  • Ora Lux
    • 3
  • James Kench
    • 4
  • Jacob George
    • 1
    Email author
  1. 1.Storr Liver Unit, Westmead Millennium InstituteUniversity of Sydney at Westmead HospitalSydneyAustralia
  2. 2.Departamento de GastroenterologíaPontificia Universidad CatólicaSantiagoChile
  3. 3.Department of Clinical ChemistryPrince of Wales HospitalSydneyAustralia
  4. 4.Department of Anatomical PathologyRoyal Prince Alfred HospitalSydneyAustralia

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