Oxidative stress is closely associated with insulin resistance in genotypes 1 and 3 chronic hepatitis C
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- Hashemi, S.M., van der Poorten, D., Barrera, F. et al. Hepatol Int (2013) 7: 516. doi:10.1007/s12072-012-9400-5
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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.
KeywordsHepatitis C Insulin resistance Malondialdehyde Oxidative stress
Chronic hepatitis C
Homeostasis model assessment of insulin resistance
Body mass index
Hepatitis C virus
Reactive oxygen species
High density lipoprotein cholesterol
Low density lipoprotein cholesterol
Human immunodeficiency virus
High performance liquid chromatography
Non-structural protein 3
Non-structural protein 5A
Suppressor of cytokine signaling-3
Tumor necrosis factor-α