Race, insulin resistance and hepatic steatosis in chronic hepatitis C

January 1, 2007

Hepatology. 2007 Jan;45(1):80-7.

Race, insulin resistance and hepatic steatosis in chronic hepatitis C.

Conjeevaram HS, Kleiner DE, Everhart JE, Hoofnagle JH, Zacks S, Afdhal NH,

Wahed AS.

University of Michigan, Ann Arbor, MI.

Hepatic steatosis is common in chronic hepatitis C and has been linked to

concurrent obesity, insulin resistance, diabetes, disease severity, and poor

response to therapy. Racial differences in rates of obesity and diabetes may

contribute to racial differences in hepatic steatosis and treatment

response. The aim of the present study was to compare hepatic steatosis and

its associations between African American (AA) and Caucasian American (CA)

patients with chronic hepatitis C, genotype 1, participating in a

prospective study of peginterferon and ribavirin therapy. Liver biopsy

results were available from 194 AA patients and 205 CA patients. The 2

groups were compared for anthropometric, clinical, and biochemical features

and insulin resistance estimated by the homeostasis model assessment index

(HOMA-IR). Sixty-one percent of the AA patients and 65% of the CA patients

had hepatic steatosis (P = 0.38). In univariable analysis, steatosis was

associated with HOMA-IR, body mass index, waist circumference, serum

triglycerides, aminotransferase level, and histological scores for

inflammation and fibrosis. After adjusting for these features, AA patients

had a lower risk of steatosis than did CA patients (OR 0.54, 95% CI

0.32-0.91, P = 0.02). Insulin resistance but not steatosis was associated

with a lower rate of sustained virological response when adjusted for known

factors that predict response (relative risk 0.87, 95% CI 0.77-0.99, P =

0.028). Conclusion: After adjusting for the higher prevalence of features

associated with hepatic steatosis, AA patients had a lower prevalence of

hepatic steatosis than did CA patients with chronic hepatitis C, genotype 1.

Insulin resistance but not steatosis was independently associated with lower

sustained virological response. (HEPATOLOGY 2006;45:80-87.).

PMID: 17187406 [PubMed - in process]

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January 1, 2007