Prospective study of liver transplant recipients with HCV infection: Evidence for a causal relationship between HCV and insulin resistance

Aymin Delgado-Borrego, Yun Sheen Liu, Sergio H. Jordan, Saurabh Agrawal, Hui Zhang, Marielle Christoff, Deborah Casson, A. Benedict Cosimi, Raymond T. Chung

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

An association between hepatitis C virus (HCV) infection and insulin resistance (IR) has been recently reported. However, causality has not been established. The cross-sectional nature of most reported studies and varying degrees of fibrosis have limited definitive conclusions about the independent role of HCV in development of IR. We sought to evaluate whether HCV induces IR by prospectively analyzing a cohort of adult liver transplant (LT) recipients. A total of 34 adults (14 HCV(+) and 20 HCV(-)) who underwent consecutive LT were followed during the first year posttransplantation. IR was estimated using the homeostasis model assessment (HOMA). Univariate and multivariate repeated measures analyses and Cox regression models were used. There were no significant differences between the groups with respect to age, body mass index (BMI), family history of diabetes, alcohol consumption, or laboratory indices. The cohort had no or minimal fibrosis. There was lower prednisone use in the HCV(+) group, and no difference in the use of tacrolimus between the two groups was found. IR was 77% higher in HCV(+) subjects during the first year post-LT when controlling for BMI (P = 0,035). Subjects with high HCV ribonucleic acid (RNA) levels reached high HOMA-IR significantly earlier than those with lower HCV RNA (P = 0.03). Following the first month post-LT, HCV(+) subjects were 4 times more likely to become diabetic than HCV(-) controls (P < 0.01). In conclusion, there is significantly higher IR in the HCV(+) group during the first year post-LT. This cannot be explained by differences in BMI, medications used, alcohol consumption, or degree of fibrosis. Higher HCV RNA levels were associated with earlier elevations in HOMA-IR. Collectively, these results provide strong evidence that HCV induces the development of IR.

Original languageEnglish
Pages (from-to)193-201
Number of pages9
JournalLiver Transplantation
Volume14
Issue number2
DOIs
StatePublished - Feb 1 2008

Fingerprint

Virus Diseases
Hepacivirus
Insulin Resistance
Prospective Studies
Liver
Transplants
Body Mass Index
Homeostasis
Fibrosis
RNA
Transplant Recipients
Alcohol Drinking
Tacrolimus
Prednisone
Proportional Hazards Models
Causality

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Delgado-Borrego, A., Liu, Y. S., Jordan, S. H., Agrawal, S., Zhang, H., Christoff, M., ... Chung, R. T. (2008). Prospective study of liver transplant recipients with HCV infection: Evidence for a causal relationship between HCV and insulin resistance. Liver Transplantation, 14(2), 193-201. https://doi.org/10.1002/lt.21267

Prospective study of liver transplant recipients with HCV infection : Evidence for a causal relationship between HCV and insulin resistance. / Delgado-Borrego, Aymin; Liu, Yun Sheen; Jordan, Sergio H.; Agrawal, Saurabh; Zhang, Hui; Christoff, Marielle; Casson, Deborah; Cosimi, A. Benedict; Chung, Raymond T.

In: Liver Transplantation, Vol. 14, No. 2, 01.02.2008, p. 193-201.

Research output: Contribution to journalArticle

Delgado-Borrego, A, Liu, YS, Jordan, SH, Agrawal, S, Zhang, H, Christoff, M, Casson, D, Cosimi, AB & Chung, RT 2008, 'Prospective study of liver transplant recipients with HCV infection: Evidence for a causal relationship between HCV and insulin resistance', Liver Transplantation, vol. 14, no. 2, pp. 193-201. https://doi.org/10.1002/lt.21267
Delgado-Borrego, Aymin ; Liu, Yun Sheen ; Jordan, Sergio H. ; Agrawal, Saurabh ; Zhang, Hui ; Christoff, Marielle ; Casson, Deborah ; Cosimi, A. Benedict ; Chung, Raymond T. / Prospective study of liver transplant recipients with HCV infection : Evidence for a causal relationship between HCV and insulin resistance. In: Liver Transplantation. 2008 ; Vol. 14, No. 2. pp. 193-201.
@article{a821f23f999d46c3b02f305731c005c5,
title = "Prospective study of liver transplant recipients with HCV infection: Evidence for a causal relationship between HCV and insulin resistance",
abstract = "An association between hepatitis C virus (HCV) infection and insulin resistance (IR) has been recently reported. However, causality has not been established. The cross-sectional nature of most reported studies and varying degrees of fibrosis have limited definitive conclusions about the independent role of HCV in development of IR. We sought to evaluate whether HCV induces IR by prospectively analyzing a cohort of adult liver transplant (LT) recipients. A total of 34 adults (14 HCV(+) and 20 HCV(-)) who underwent consecutive LT were followed during the first year posttransplantation. IR was estimated using the homeostasis model assessment (HOMA). Univariate and multivariate repeated measures analyses and Cox regression models were used. There were no significant differences between the groups with respect to age, body mass index (BMI), family history of diabetes, alcohol consumption, or laboratory indices. The cohort had no or minimal fibrosis. There was lower prednisone use in the HCV(+) group, and no difference in the use of tacrolimus between the two groups was found. IR was 77{\%} higher in HCV(+) subjects during the first year post-LT when controlling for BMI (P = 0,035). Subjects with high HCV ribonucleic acid (RNA) levels reached high HOMA-IR significantly earlier than those with lower HCV RNA (P = 0.03). Following the first month post-LT, HCV(+) subjects were 4 times more likely to become diabetic than HCV(-) controls (P < 0.01). In conclusion, there is significantly higher IR in the HCV(+) group during the first year post-LT. This cannot be explained by differences in BMI, medications used, alcohol consumption, or degree of fibrosis. Higher HCV RNA levels were associated with earlier elevations in HOMA-IR. Collectively, these results provide strong evidence that HCV induces the development of IR.",
author = "Aymin Delgado-Borrego and Liu, {Yun Sheen} and Jordan, {Sergio H.} and Saurabh Agrawal and Hui Zhang and Marielle Christoff and Deborah Casson and Cosimi, {A. Benedict} and Chung, {Raymond T.}",
year = "2008",
month = "2",
day = "1",
doi = "10.1002/lt.21267",
language = "English",
volume = "14",
pages = "193--201",
journal = "Liver Transplantation",
issn = "1527-6465",
publisher = "John Wiley and Sons Ltd",
number = "2",

}

TY - JOUR

T1 - Prospective study of liver transplant recipients with HCV infection

T2 - Evidence for a causal relationship between HCV and insulin resistance

AU - Delgado-Borrego, Aymin

AU - Liu, Yun Sheen

AU - Jordan, Sergio H.

AU - Agrawal, Saurabh

AU - Zhang, Hui

AU - Christoff, Marielle

AU - Casson, Deborah

AU - Cosimi, A. Benedict

AU - Chung, Raymond T.

PY - 2008/2/1

Y1 - 2008/2/1

N2 - An association between hepatitis C virus (HCV) infection and insulin resistance (IR) has been recently reported. However, causality has not been established. The cross-sectional nature of most reported studies and varying degrees of fibrosis have limited definitive conclusions about the independent role of HCV in development of IR. We sought to evaluate whether HCV induces IR by prospectively analyzing a cohort of adult liver transplant (LT) recipients. A total of 34 adults (14 HCV(+) and 20 HCV(-)) who underwent consecutive LT were followed during the first year posttransplantation. IR was estimated using the homeostasis model assessment (HOMA). Univariate and multivariate repeated measures analyses and Cox regression models were used. There were no significant differences between the groups with respect to age, body mass index (BMI), family history of diabetes, alcohol consumption, or laboratory indices. The cohort had no or minimal fibrosis. There was lower prednisone use in the HCV(+) group, and no difference in the use of tacrolimus between the two groups was found. IR was 77% higher in HCV(+) subjects during the first year post-LT when controlling for BMI (P = 0,035). Subjects with high HCV ribonucleic acid (RNA) levels reached high HOMA-IR significantly earlier than those with lower HCV RNA (P = 0.03). Following the first month post-LT, HCV(+) subjects were 4 times more likely to become diabetic than HCV(-) controls (P < 0.01). In conclusion, there is significantly higher IR in the HCV(+) group during the first year post-LT. This cannot be explained by differences in BMI, medications used, alcohol consumption, or degree of fibrosis. Higher HCV RNA levels were associated with earlier elevations in HOMA-IR. Collectively, these results provide strong evidence that HCV induces the development of IR.

AB - An association between hepatitis C virus (HCV) infection and insulin resistance (IR) has been recently reported. However, causality has not been established. The cross-sectional nature of most reported studies and varying degrees of fibrosis have limited definitive conclusions about the independent role of HCV in development of IR. We sought to evaluate whether HCV induces IR by prospectively analyzing a cohort of adult liver transplant (LT) recipients. A total of 34 adults (14 HCV(+) and 20 HCV(-)) who underwent consecutive LT were followed during the first year posttransplantation. IR was estimated using the homeostasis model assessment (HOMA). Univariate and multivariate repeated measures analyses and Cox regression models were used. There were no significant differences between the groups with respect to age, body mass index (BMI), family history of diabetes, alcohol consumption, or laboratory indices. The cohort had no or minimal fibrosis. There was lower prednisone use in the HCV(+) group, and no difference in the use of tacrolimus between the two groups was found. IR was 77% higher in HCV(+) subjects during the first year post-LT when controlling for BMI (P = 0,035). Subjects with high HCV ribonucleic acid (RNA) levels reached high HOMA-IR significantly earlier than those with lower HCV RNA (P = 0.03). Following the first month post-LT, HCV(+) subjects were 4 times more likely to become diabetic than HCV(-) controls (P < 0.01). In conclusion, there is significantly higher IR in the HCV(+) group during the first year post-LT. This cannot be explained by differences in BMI, medications used, alcohol consumption, or degree of fibrosis. Higher HCV RNA levels were associated with earlier elevations in HOMA-IR. Collectively, these results provide strong evidence that HCV induces the development of IR.

UR - http://www.scopus.com/inward/record.url?scp=39449099338&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=39449099338&partnerID=8YFLogxK

U2 - 10.1002/lt.21267

DO - 10.1002/lt.21267

M3 - Article

C2 - 18236394

AN - SCOPUS:39449099338

VL - 14

SP - 193

EP - 201

JO - Liver Transplantation

JF - Liver Transplantation

SN - 1527-6465

IS - 2

ER -