Hépato-Gastroentérologie, Hôpital Saint-Pierre, Université Libre de Bruxelles, Bruxelles, Belgium.
Liver Int. 2010 Sep;30(8):1131-6. doi: 10.1111/j.1478-3231.2010.02291.x. Epub 2010 Jun 9.
BACKGROUND & AIM: Patients with hepatitis C virus (HCV) infection, especially those with genotypes 1 and 4, have an increased risk of developing metabolic disorders. The aim of this study was to evaluate the associations among metabolic disorders, ethnicity and genotype in a large cohort of patients with chronic hepatitis C (CHC).
All consecutive patients with CHC who were seen in our hepato-gastroenterology unit between January 2002 and September 2008 were included. Demographical data and variables related to the metabolic syndrome were collected. Insulin resistance was assessed using the homeostasis model for the assessment of insulin resistance test (HOMA-IR) test.
Among the 454 CHC patients, the prevalence of the metabolic syndrome was 12.4%. The HOMA-IR test was performed in 140 patients, and 35.0% had insulin resistance. There were more Black Africans among the patients with genotypes 1/4 than among those with genotypes 2/3 (32.0 vs 1.2%, P<0.0001). Insulin resistance was more common in patients with genotypes 1/4 than in those with genotypes 2/3 (17 vs 1.7%, P=0.0001 and 43.3 vs 16.3%, P=0.001, respectively). Genotypes 1/4 were more frequently present in patients with insulin resistance than in those without insulin resistance (85.7 vs 60.5%, P=0.001). By logistic regression, genotypes 1/4 [odds ratio (OR)=2.79; 95% confidence interval (CI): 1.09-7.12, P=0.032] and older age (OR=1.03; 95% CI: 1.004-1.06, P=0.024) were independently associated with the presence of insulin resistance.
In CHC, insulin resistance is independently associated with the presence of genotypes 1/4. Ethnicity is not independently associated with metabolic disorders in patients with CHC.
丙型肝炎病毒（HCV）感染患者，尤其是基因型 1 和 4 感染者，发生代谢紊乱的风险增加。本研究旨在评估代谢紊乱、种族和基因型在大规模慢性丙型肝炎（CHC）患者中的相关性。
纳入 2002 年 1 月至 2008 年 9 月期间在我院消化内科门诊就诊的所有 CHC 患者。收集患者的人口统计学数据和代谢综合征相关变量。采用稳态模型评估胰岛素抵抗指数（HOMA-IR）评估胰岛素抵抗。
454 例 CHC 患者中，代谢综合征的患病率为 12.4%。对 140 例患者进行了 HOMA-IR 检测，其中 35.0%存在胰岛素抵抗。基因型 1/4 的患者中黑种非洲人比例高于基因型 2/3 的患者（32.0% vs 1.2%，P<0.0001）。基因型 1/4 的患者胰岛素抵抗的发生率高于基因型 2/3 的患者（17% vs 1.7%，P=0.0001 和 43.3% vs 16.3%，P=0.001）。基因型 1/4 的患者胰岛素抵抗的发生率高于无胰岛素抵抗的患者（85.7% vs 60.5%，P=0.001）。通过逻辑回归分析，基因型 1/4（比值比（OR）=2.79；95%置信区间（CI）：1.09-7.12，P=0.032）和年龄较大（OR=1.03；95%CI：1.004-1.06，P=0.024）与胰岛素抵抗的存在独立相关。
在 CHC 中，胰岛素抵抗与基因型 1/4 独立相关。种族与 CHC 患者的代谢紊乱无关。
