Metabolic syndrome in patients with chronic hepatitis C virus genotype 1 infection who do not have obesity or type 2 diabetes

Abstract

OBJECTIVE:The individual components of metabolic syndrome may be independent predictors of mortality in patients with liver disease. We aimed to evaluate the prevalence of metabolic syndrome and its related components in hepatitis C virus–infected patients who are not obese and do not have type 2 diabetes.METHODS:This cross-sectional study included 125 patients infected with hepatitis C virus genotype 1. Metabolic syndrome was defined according to the International Diabetes Federation. Anthropometric data were measured according to standardized procedures. Bioimpedance analysis was performed on all patients.RESULTS:Metabolic syndrome was diagnosed in 21.6% of patients. Of the subjects with metabolic syndrome, 59.3% had hypertension, 77.8% had insulin resistance, 85.2% were overweight, 48.1% had a high waist circumference, 85.2% had an increased body fat percentage, and 92.3% had an elevated waist:hip ratio. In the bivariate analysis, female sex (OR 2.58; 95% CI: 1.09–6.25), elevated gamma-glutamyl transferase (γGT) (OR 2.63; 95% CI: 1.04–7.29), elevated fasting glucose (OR 8.05; 95% CI: 3.17-21.32), low HDL cholesterol (OR 2.80; 95% CI: 1.07–7.16), hypertriglyceridemia (OR 7.91; 95% CI: 2.88–22.71), elevated waist circumference (OR 10.33; 95% CI: 3.72–30.67), overweight (OR 11.33; 95% CI: 3.97–41.07), and increased body fat percentage (OR 8.34; 95% CI: 2.94–30.08) were independent determinants of metabolic syndrome. Using the final multivariate regression model, similar results were observed for abdominal fat (OR 9.98; 95% CI: 2.63–44.41) and total body fat percentage (OR 8.73; 95% CI: 2.33–42.34). However, metabolic syndrome risk was also high for those with blood glucose ≥5.55 mmol/L or HDL cholesterol <0.9 mmol/L (OR 16.69; 95% CI: 4.64–76.35; OR 7.23; 95% CI: 1.86–32.63, respectively).CONCLUSION:Metabolic syndrome is highly prevalent among hepatitis C virus–infected patients without type 2 diabetes or obesity. Metabolic syndrome was significantly associated with hypertension, insulin resistance, increased abdominal fat, and overweight.

Association between the hepatitis B and C viruses and metabolic diseases in patients stratified by age

“…The severity of HBV-and HCV-related liver diseases and rate of disease progression are impacted by age, gender, host factors, exposure to alcohol, coinfections, viral genotype and MS (11). In addition, the individual components of MS might also be independent predictors of morbidity/mortality in patients with liver diseases, such as those caused by HBV or HCV (12). A multitude of other studies have also reported that HCV is a risk for MS and/or various individual components of MS, including IR as cited in Negro and, more recently, the review articles by HBsAg positive rate (%) 15 Sheikh et al and Del Campo and Romero-G omez (13)(14)(15).…”

Genetic variation in the microsomal triglyceride transfer protein (−493G/T) is associated with hepatic steatosis in patients infected with hepatitis C virus

“…Perls’ staining with score of 0–4 was applied to assess hepatic siderosis. Based on data from the insulin secretion and fasting glucose analyses, the HOMA-IR (homeostasis model assessment of insulin resistance) index of the patients was calculated and patients who presented HOMA-IR ≥3.0 were considered to have insulin resistance [16, 17]. …”

Lipoprotein lipase liberates free fatty acids to inhibit HCV infection and prevent hepatic lipid accumulation

“…Hepatitis C virus (HCV) threatens human health; an estimated >185 million infected persons globally (Hanafiah, Groeger, Flaxman, & Wiersma, 2013) are at risk of developing hepatic diseases, including hepatitis, liver cirrhosis, and hepatocellular carcinoma (Sanyal, Yoon, & Lencioni, 2010), as well as metabolic disorders, including insulin resistance (Milner et al, 2010) and metabolic syndrome (Oliveira et al, 2012). The incidence of HCV infection has been in decline since 1990s, but the burden of HCV-related advanced disease will continue to rise for the next two decades (Razavi et al, 2013).…”