Scalioni Letícia de Paula, da Silva Allan Peres, Miguel Juliana Custódio, Espírito Santo Márcia Paschoal do, Marques Vanessa Alves, Brandão-Mello Carlos Eduardo, Villela-Nogueira Cristiane Alves, Lewis-Ximenez Lia Laura, Lampe Elisabeth, Villar Livia Melo
Livia Melo Villar, Viral Hepatitis Laboratory, Helio and Peggy Pereira Pavilion, Ground Floor, Room B09, FIOCRUZ Av. Brasil, 4365-Manguinhos, Rio de Janeiro, RJ 210360-040, Brazil.
Gaffrée & Guinle University Hospital, Federal University of Rio de Janeiro State, Rio de Janeiro, RJ 20270-001, Brazil.
Int J Mol Sci. 2017 Jul 21;18(7):1444. doi: 10.3390/ijms18071444.
The role of hepatitis C virus (HCV) in insulin resistance (IR) is not fully understood. The aim of this study was to determine the impact of amino acid (aa) substitutions in the region of HCV according to IR and to identify clinical and laboratory associations. Ninety-two treatment-naive HCV patients were recruited to determine laboratory data and blood cell count. IR was determined using Homeostasis Model Assessment (HOMA) index where IR was defined as HOMA ≥2. HCV RNA load and genotype were determined by Abbott Real time HCV. HCV region was determined by direct nucleotide sequencing. Bivariate analysis was conducted using HOMA IR ≥2 as a dependent factor. IR prevalence was 43.5% ( = 40), vitamin D sufficiency was found in 76.1% ( = 70) and 72.8% ( = 67) had advanced liver fibrosis. In the bivariate analyses, elevated values of γGT ( = 0.024) and fibrosis staging ( = 0.004) were associated with IR, but IR was not related to core mutations. The presence of glutamine in position 70 was associated with low vitamin D concentration ( = 0.005). In the multivariate analysis, no variable was independently associated with HOMA-IR. In conclusion, lack of association between IR and HCV core mutations in positions 70 and 91 suggests that genetic variability of this region has little impact on IR.
丙型肝炎病毒（HCV）在胰岛素抵抗（IR）中的作用尚未完全明确。本研究旨在根据胰岛素抵抗情况确定HCV 区域氨基酸（aa）替换的影响，并确定临床和实验室之间的关联。招募了92例未经治疗的HCV患者以确定实验室数据和血细胞计数。使用稳态模型评估（HOMA）指数确定胰岛素抵抗，其中胰岛素抵抗定义为HOMA≥2。通过雅培实时HCV检测HCV RNA载量和基因型。通过直接核苷酸测序确定HCV 区域。以HOMA IR≥2作为因变量进行双变量分析。胰岛素抵抗患病率为43.5%（n = 40），76.1%（n = 70）的患者维生素D充足，72.8%（n = 67）的患者有晚期肝纤维化。在双变量分析中，γGT值升高（P = 0.024）和纤维化分期（P = 0.004）与胰岛素抵抗相关，但胰岛素抵抗与核心突变无关。70位存在谷氨酰胺与低维生素D浓度相关（P = 0.005）。在多变量分析中，没有变量与HOMA-IR独立相关。总之，70位和91位的胰岛素抵抗与HCV核心突变之间缺乏关联，表明该区域的基因变异性对胰岛素抵抗影响很小。
