Hepatitis C virus is independently associated with increased insulin resistance after liver transplantation

Aymin Delgado-Borrego, Deborah Casson, David Schoenfeld, Ma Somsouk, Adam Terella, Sergio H. Jordan, Atul Bhan, Seema Baid, A. Benedict Cosimi, Manuel Pascual, Raymond T. Chung

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Abstract

Background and Aims. There is a strong epidemiologic association between diabetes mellitus (DM) and hepatitis C virus (HCV) infection. However, the pathogenetic basis for this association has not been established. We sought to evaluate the association between insulin resistance (IR), β-cell dysfunction, and HCV among orthotopic liver transplant (OLT) recipients. Methods. We performed a cross sectional analysis comparing 39 HCV(+) with 60 HCV(-) OLT recipients. IR and β-cell function were calculated using validated measures and were correlated with clinical variables. Results. By multivariate analysis of the entire cohort, HCV infection and body mass index (BMI) were independent predictors of IR (P=0.04 and 0.0006, respectively). HCV infection was associated with 35% increase in IR. Because the model used to calculate IR was derived from nondiabetic subjects, we performed additional analysis of patients who did not meet criteria for diabetes at the time of their study evaluation. In this analysis, HCV(+) subjects had greater fasting insulin and homeostasis model assessment (HOMA) IR (15.3 μ U/mL and 3.8) compared with HCV(-) patients (10.7 μ U/mL and 2.5) (P=0.03, 0.03). There was no difference in β-cell function or hepatic insulin extraction between the HCV (+) and (-) groups. HCV (P=0.0005), BMI (P<0.0001), and high high-density lipoprotein (P=0.039) were the only independent predictors of IR. The presence of HCV infection and a 10-fold increase in HCV RNA were associated with a 62% and 8% increase in IR, respectively. Conclusions. HCV is independently associated with increased IR after OLT. These findings provide a possible pathogenetic basis for the association of DM with HCV.

Original languageEnglish
Pages (from-to)703-710
Number of pages8
JournalTransplantation
Volume77
Issue number5
DOIs
StatePublished - Mar 15 2004

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Hepacivirus
Liver Transplantation
Insulin Resistance
Virus Diseases
Liver
Diabetes Mellitus
Body Mass Index
Insulin
HDL Lipoproteins
Fasting
Homeostasis
Multivariate Analysis
Cross-Sectional Studies
RNA

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Delgado-Borrego, A., Casson, D., Schoenfeld, D., Somsouk, M., Terella, A., Jordan, S. H., ... Chung, R. T. (2004). Hepatitis C virus is independently associated with increased insulin resistance after liver transplantation. Transplantation, 77(5), 703-710. https://doi.org/10.1097/01.TP.0000114283.04840.3A

Hepatitis C virus is independently associated with increased insulin resistance after liver transplantation. / Delgado-Borrego, Aymin; Casson, Deborah; Schoenfeld, David; Somsouk, Ma; Terella, Adam; Jordan, Sergio H.; Bhan, Atul; Baid, Seema; Cosimi, A. Benedict; Pascual, Manuel; Chung, Raymond T.

In: Transplantation, Vol. 77, No. 5, 15.03.2004, p. 703-710.

Research output: Contribution to journalArticle

Delgado-Borrego, A, Casson, D, Schoenfeld, D, Somsouk, M, Terella, A, Jordan, SH, Bhan, A, Baid, S, Cosimi, AB, Pascual, M & Chung, RT 2004, 'Hepatitis C virus is independently associated with increased insulin resistance after liver transplantation', Transplantation, vol. 77, no. 5, pp. 703-710. https://doi.org/10.1097/01.TP.0000114283.04840.3A
Delgado-Borrego, Aymin ; Casson, Deborah ; Schoenfeld, David ; Somsouk, Ma ; Terella, Adam ; Jordan, Sergio H. ; Bhan, Atul ; Baid, Seema ; Cosimi, A. Benedict ; Pascual, Manuel ; Chung, Raymond T. / Hepatitis C virus is independently associated with increased insulin resistance after liver transplantation. In: Transplantation. 2004 ; Vol. 77, No. 5. pp. 703-710.
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abstract = "Background and Aims. There is a strong epidemiologic association between diabetes mellitus (DM) and hepatitis C virus (HCV) infection. However, the pathogenetic basis for this association has not been established. We sought to evaluate the association between insulin resistance (IR), β-cell dysfunction, and HCV among orthotopic liver transplant (OLT) recipients. Methods. We performed a cross sectional analysis comparing 39 HCV(+) with 60 HCV(-) OLT recipients. IR and β-cell function were calculated using validated measures and were correlated with clinical variables. Results. By multivariate analysis of the entire cohort, HCV infection and body mass index (BMI) were independent predictors of IR (P=0.04 and 0.0006, respectively). HCV infection was associated with 35{\%} increase in IR. Because the model used to calculate IR was derived from nondiabetic subjects, we performed additional analysis of patients who did not meet criteria for diabetes at the time of their study evaluation. In this analysis, HCV(+) subjects had greater fasting insulin and homeostasis model assessment (HOMA) IR (15.3 μ U/mL and 3.8) compared with HCV(-) patients (10.7 μ U/mL and 2.5) (P=0.03, 0.03). There was no difference in β-cell function or hepatic insulin extraction between the HCV (+) and (-) groups. HCV (P=0.0005), BMI (P<0.0001), and high high-density lipoprotein (P=0.039) were the only independent predictors of IR. The presence of HCV infection and a 10-fold increase in HCV RNA were associated with a 62{\%} and 8{\%} increase in IR, respectively. Conclusions. HCV is independently associated with increased IR after OLT. These findings provide a possible pathogenetic basis for the association of DM with HCV.",
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T1 - Hepatitis C virus is independently associated with increased insulin resistance after liver transplantation

AU - Delgado-Borrego, Aymin

AU - Casson, Deborah

AU - Schoenfeld, David

AU - Somsouk, Ma

AU - Terella, Adam

AU - Jordan, Sergio H.

AU - Bhan, Atul

AU - Baid, Seema

AU - Cosimi, A. Benedict

AU - Pascual, Manuel

AU - Chung, Raymond T.

PY - 2004/3/15

Y1 - 2004/3/15

N2 - Background and Aims. There is a strong epidemiologic association between diabetes mellitus (DM) and hepatitis C virus (HCV) infection. However, the pathogenetic basis for this association has not been established. We sought to evaluate the association between insulin resistance (IR), β-cell dysfunction, and HCV among orthotopic liver transplant (OLT) recipients. Methods. We performed a cross sectional analysis comparing 39 HCV(+) with 60 HCV(-) OLT recipients. IR and β-cell function were calculated using validated measures and were correlated with clinical variables. Results. By multivariate analysis of the entire cohort, HCV infection and body mass index (BMI) were independent predictors of IR (P=0.04 and 0.0006, respectively). HCV infection was associated with 35% increase in IR. Because the model used to calculate IR was derived from nondiabetic subjects, we performed additional analysis of patients who did not meet criteria for diabetes at the time of their study evaluation. In this analysis, HCV(+) subjects had greater fasting insulin and homeostasis model assessment (HOMA) IR (15.3 μ U/mL and 3.8) compared with HCV(-) patients (10.7 μ U/mL and 2.5) (P=0.03, 0.03). There was no difference in β-cell function or hepatic insulin extraction between the HCV (+) and (-) groups. HCV (P=0.0005), BMI (P<0.0001), and high high-density lipoprotein (P=0.039) were the only independent predictors of IR. The presence of HCV infection and a 10-fold increase in HCV RNA were associated with a 62% and 8% increase in IR, respectively. Conclusions. HCV is independently associated with increased IR after OLT. These findings provide a possible pathogenetic basis for the association of DM with HCV.

AB - Background and Aims. There is a strong epidemiologic association between diabetes mellitus (DM) and hepatitis C virus (HCV) infection. However, the pathogenetic basis for this association has not been established. We sought to evaluate the association between insulin resistance (IR), β-cell dysfunction, and HCV among orthotopic liver transplant (OLT) recipients. Methods. We performed a cross sectional analysis comparing 39 HCV(+) with 60 HCV(-) OLT recipients. IR and β-cell function were calculated using validated measures and were correlated with clinical variables. Results. By multivariate analysis of the entire cohort, HCV infection and body mass index (BMI) were independent predictors of IR (P=0.04 and 0.0006, respectively). HCV infection was associated with 35% increase in IR. Because the model used to calculate IR was derived from nondiabetic subjects, we performed additional analysis of patients who did not meet criteria for diabetes at the time of their study evaluation. In this analysis, HCV(+) subjects had greater fasting insulin and homeostasis model assessment (HOMA) IR (15.3 μ U/mL and 3.8) compared with HCV(-) patients (10.7 μ U/mL and 2.5) (P=0.03, 0.03). There was no difference in β-cell function or hepatic insulin extraction between the HCV (+) and (-) groups. HCV (P=0.0005), BMI (P<0.0001), and high high-density lipoprotein (P=0.039) were the only independent predictors of IR. The presence of HCV infection and a 10-fold increase in HCV RNA were associated with a 62% and 8% increase in IR, respectively. Conclusions. HCV is independently associated with increased IR after OLT. These findings provide a possible pathogenetic basis for the association of DM with HCV.

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