Increased insulin resistance and hyperinsulinemia in patients with type 2 diabetes and chronic hepatitis C

Oliveira, Beatriz R.; Magalhães, Otávio de Azevedo; Furlanetto, Tânia Weber; Bertoluci, Marcello Casaccia

doi:10.1016/j.diabres.2007.08.003

Cited by 5 publications

(3 citation statements)

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“…The association of type 2 DM and HCV infection might be due to an increased susceptibility of type 2 DM patients to more frequent hospitalizations and daily use of syringes (10). Alternatively, HCV infection might predispose patients to the development of type 2 DM, by interfering in lipid metabolism, inhibiting signaling pathways in the liver, increasing hepatic steatosis and then inducing insulin resistance (5,15,26,27). However, the exact mechanism of insulin resistance induced by HCV remains to be clarified.…”

Section: Discussionmentioning

confidence: 99%

Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection

Greca

Pinto

Rados

et al. 2012

Braz J Med Biol Res

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The objective of the present cross-sectional study was to assess the prevalence and the clinical and laboratory features of hepatitis C virus (HCV)-positive patients with type 2 diabetes mellitus (DM) attending either an outpatient clinic or hemodialysis units. Serologic-HCV testing was performed in 489 type 2 DM patients (303 outpatients and 186 on dialysis). A structured assessment of clinical, laboratory and DM-related complications was performed and the patients were then compared according to HCV infection status. Mean patient age was 60 years; HCV positivity (HCV+) was observed in 39 of 303 (12.9%) outpatients and in 34 of 186 (18.7%) dialysis patients. Among HCV+ patients, 32 were men (43.8%). HCV+ patients had higher serum levels of aspartate aminotransferase (0.90 ± 0.83 vs 0.35 ± 0.13 μKat/L), alanine aminotransferase (0.88 ± 0.93 vs 0.38 ± 0.19 μKat/L), gamma-glutamyl transferase (1.57 ± 2.52 vs 0.62 ± 0.87 μKat/L; P < 0.001), and serum iron (17.65 ± 6.68 vs 14.96 ± 4.72 μM; P = 0.011), and lower leukocyte and platelet counts (P = 0.010 and P < 0.001, respectively) than HCV-negative (HCV-) patients. HCV+ dialysis patients had higher diastolic blood pressure than HCV- patients (87.5 ± 6.7 vs 81.5 ± 6.0 mmHg; P = 0.005) and a lower prevalence of diabetic retinopathy (75 vs 92.7%; P = 0.007). In conclusion, our study showed that HCV is common among subjects with type 2 DM but is not associated with a higher prevalence of chronic diabetic complications.

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Section: Discussionmentioning

confidence: 99%

Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection

Greca

Pinto

Rados

et al. 2012

Braz J Med Biol Res

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“…Today, the relevance of adiposetissue as an important source of pro-inflammatory molecules, such as tumoral necrosis factor alpha (TNF-α) and interleukin-1β (IL-1β), which are linked to insulin resistance, is well known [2]. Insulin resistance and hyperinsulinemia have been reported in patients with T2 DM and chronic C hepatitis [3]. Likewise, insulin resistance and high HOMA scores have been determined in patients with hepatitis C [4].…”

Section: Introductionmentioning

confidence: 99%

Levels of TNF-α, IL-1β, TGF-β, and IL-6 in patients with chronic hepatitis C virus infection and hyperinsulinemia

Salazar¹,

García-Samper²,

Alcázar-Leyva³

et al. 2013

OJI

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Background: Previous evidences support to inflammatory process associated with the IR those important factors in the development of fibrosis and hepatic damage in patients with HCV infection. Objectives: Determine the presence of immunological or histological differentces between hyperinsulinemic and non-hyperinsulinemic chronic HCV-infected patients with at least 10 years of evolution. Material and Methods: The body mass index, Child-Puigh score, liver function tests, and biochemical profile were evaluated in 30 control, 40 chronic HCV-infected patients with hyperinsulinemia, and in 40 normoinsulinemic chronic HCV-infected patients with at least 10 years of evolution. In addition, HCV genotype and viral load were established with the Amplicor System. In addition, nitrites in plasma, and TNF-α, IL-1β, TGF-β, IL-6, and insulin levels were determined. Results: No differences were found in BMI, Child-Pugh "A" scores, ALT, viral load, or genotype between the hyperinsulinemic (>25 IU/ml) and normoinsulinemic (<25 IU/ml) patients. Hyperinsulinemia patients had a higher HOMA-IR value (13.6) than normoinsulinemia patients (3.4), and none had a glycemia > 126 mg/dl. Cytokines concentration did not show differences with respect to controls. Nitrites showed a slight increase only in patients with HCV infection. Conclusions: Absence of changes in the proinflammatory cytokines concentration or in some inflammation markers in chronic HCV patients with hyperinsulinemia suggests that long-term insulin levels, in presence of HCV, cannot explain by themselves the hepatic alterations ob-served in the patient with HCV infection, the presence of others elements (alcoholism, cirrhosis, etc.) is necessary to onset hepatic damage in these patients.

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“…Essa prevalência é ainda maior entre os indivíduos com cirrose hepática quando comparado com os que possuem infecção crônica por HCV e não apresentam cirrose. Geralmente, a resistência à insulina pode levar a consequências clínicas, como progressão para diabetes mellitus tipo 2 e aumento do risco de doença cardiovascular em pacientes com hepatite C crônica (Oliveira et al, 2008;Adinolfi et al, 2016;Shawky et al, 2020).…”

Section: Tratamento Da Hepatite Cunclassified

Influência de polimorfismos no gene MTTP nos níveis de lipídeos e na esteatose associada à infecção crônica pelo vírus da hepatite C

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Aos meus pais, João e Elisabete, pelo apoio incondicional e por sempre me incentivarem a continuar buscando novos desafios.À minha irmã, Cynthia, por todo o carinho, apoio e força nos momentos mais difíceis.Ao meu marido Pedro, que compartilha essa caminhada comigo, incentivando e vibrando a cada conquista. À minha orientadora Profa. Dra. Mariana Cavalheiro Magri, por tantos ensinamentos durante esses anos. Sou muito grata por todas as oportunidades, confiança, paciência, disponibilidade e ajuda em diversos momentos. Foi uma honra ter sido sua aluna! À minha co-orientadora Profa. Dra. Fátima Mitiko Tengan, por todo o auxílio, ensinamentos e oportunidades de crescimento concedidas durante esses anos. Aos Professores Dr. Edson Abdala, Dra. Alice Tung Wan Song e Dra. Nayara Izabel Viana pelas diversas contribuições e recomendações durante o exame de qualificação.Ao Prof. Dr. Antonio Alci Barone, um grande exemplo para todos.A toda a equipe do LIM-47, pela amizade, apoio e ajuda com esse trabalho. Além disso, sou muito grata por tantos momentos alegres e pelo convívio nesses anos.

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Increased insulin resistance and hyperinsulinemia in patients with type 2 diabetes and chronic hepatitis C

Cited by 5 publications

References 4 publications

Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection

Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection

Levels of TNF-<i>α</i>, IL-1<i>β</i>, TGF-<i>β</i>, and IL-6 in patients with chronic hepatitis C virus infection and hyperinsulinemia

Influência de polimorfismos no gene MTTP nos níveis de lipídeos e na esteatose associada à infecção crônica pelo vírus da hepatite C

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Increased insulin resistance and hyperinsulinemia in patients with type 2 diabetes and chronic hepatitis C

Cited by 5 publications

References 4 publications

Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection

Clinical features of patients with type 2 diabetes mellitus and hepatitis C infection

Levels of TNF-&lt;i&gt;α&lt;/i&gt;, IL-1&lt;i&gt;β&lt;/i&gt;, TGF-&lt;i&gt;β&lt;/i&gt;, and IL-6 in patients with chronic hepatitis C virus infection and hyperinsulinemia

Influência de polimorfismos no gene MTTP nos níveis de lipídeos e na esteatose associada à infecção crônica pelo vírus da hepatite C

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Levels of TNF-<i>α</i>, IL-1<i>β</i>, TGF-<i>β</i>, and IL-6 in patients with chronic hepatitis C virus infection and hyperinsulinemia