Risk of metabolic syndrome in patients with chronic hepatitis C

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Published Aug 24, 2023
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Vol. 101 No. 3 (2023): Tunis Med mars 2023

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Mouna Medhioub
Département de gastro-entérologie, Hôpital Mohamed Taher Maamouri , Nabeul - Tunisie / Université de Tunis el Manar , faculté de médecine de Tunis
Amal Khsiba
Département de gastro-entérologie, Hôpital Mohamed Taher Maamouri , Nabeul - Tunisie / Université de Tunis el Manar , faculté de médecine de Tunis
Asma Bachali
Laboratoire de biochimie, Hôpital Mohamed Taher Maamouri , Nabeul - Tunisie. / Université de Tunis el Manar , faculté de médecine de Tunis
Amina Bibi
Laboratoire de biologie clinique, Institut de nutrition et de technologie alimentaire, Tunis / Université de Tunis el Manar , faculté de médecine de Tunis
Lamnie Hamzaoui
Département de gastro-entérologie, Hôpital Mohamed Taher Maamouri , Nabeul - Tunisie / Université de Tunis el Manar , faculté de médecine de Tunis
Mohamed Moussadek Azouz
Département de gastro-entérologie, Hôpital Mohamed Taher Maamouri , Nabeul - Tunisie / Université de Tunis el Manar , faculté de médecine de Tunis

Abstract

Background: Chronic hepatitis C is associated with several metabolic abnormalities including diabetes and insulin resistance. Metabolic
syndrome, a major cardiovascular risk factor, may represent an additional risk of morbidity and mortality in patients with viral hepatitis C.
Aim: To assess the risk of metabolic syndrome in patients with chronic hepatitis C and its impact on liver fibrosis.
Methods: Retrospective cohort study, including a group of exposed patients with untreated chronic hepatitis C and a group of unexposed
patients with negative hepatitis C serology. We compared the prevalence of metabolic syndrome between the two groups and evaluated
the association between metabolic syndrome and advanced fibrosis in the exposed patients.
Results: Forty exposed and 40 unexposed were included. The two groups were matched for age, sex and anthropometric data. Fibrosis
was significant in 67.5% of the exposed group. The exposed group had a significantly higher prevalence of metabolic syndrome and insulin resistance compared to the unexposed group (37.5% VS 15%; p=0.02 VS 67.5% , 37.5%; p=0.007, respectively). The relative risk of
metabolic syndrome in the exposed group was 2.5. Metabolic syndrome was not associated with significant fibrosis (p=0.7).
Conclusion: Chronic hepatitis C is a risk factor for developing metabolic syndrome.

Keywords:

hepatitis C, metabolic syndrome, fibrosis

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References

  1. Polaris Observatory HCV Collaborators. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol 2017;2(3):161–76.
  2. Nissaf Ben Alaya. Résultats de l’Enquête Nationale de Prévalence des Hépatites Virales A, B & C en Tunisie [Iternet]. 26 ème congrès national d’infectiologie 2016 . [updated 2016 April 8; cited 2020 May 29]. Available fromhttps://www.infectiologie.org.tn/pdf_ppt_docs/congres2016/1/22042016_Resultats-Enquete-Nationale-des-hepatitesViralesTunisie.pdf.
  3. Adinolfi LE, Restivo L, Zampino R, Lonardo A, Loria P. Metabolic alterations and chronic hepatitis C: treatment strategies. Expert Opin Pharmacother 2011 ;12(14):2215–34.
  4. Zampino R, Marrone A, Restivo Let al. Chronic HCV infection and inflammation: Clinical impact on hepatic and extra-hepatic manifestations. World J Hepatol 2013;5(10):528.
  5. Dyal HK, Aguilar M, Bhuket T et al. Concurrent obesity, diabetes, and steatosis increase risk of advanced fibrosis among HCV patients: a systematic review. Dig Dis Sci 2015;60:2813–24.
  6. Dyal HK, Aguilar M, Bartos G et al. Diabetes mellitus increases risk of hepatocellular carcinoma in chronic hepatitis C virus patients: a systematic review. Dig Dis Sci 2016;61:636–45.
  7. Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013 Jul;31(7):1281–357.
  8. Boursier J, de Ledinghen V, Zarski J-P et al. Comparison of eight diagnostic algorithms for liver fibrosis in hepatitis C: new algorithms are more precise and entirely noninvasive. Hepatol Baltim Md 2012 Jan;55(1):58–67.
  9. The French METAVIR Cooperative Study Group. Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. Hepatology 1994;20: 15-20 .
  10. The International Diabetes FederationConsensus Worldwide Definition of the Metabolic Syndrome [Internet]. [ updated 2017 Aug 30; cited 2020 May 29]. Available from: https://www.idf.org/e-library/consensus-statements/60-idfconsensus-worldwide-definitionof-the-metabolic-syndrome
  11. Banks DE, Bogler Y, Bhuket T, Liu B, Wong RJ. Significant disparities in risks of diabetes mellitus and metabolic syndrome among chronic hepatitis C virus exposésin the U.S. Diabetes Metab Syndr. 2017 ;11 Suppl 1:153-8.
  12. Aziz H, Gill U, Raza A, Gill ML. Metabolic syndrome is associated with poor treatment response to antiviral therapy in chronic hepatitis C genotype 3 patients. Eur J Gastroenterol Hepatol. 2014 ;26:538-43.
  13. Oliveira LP, Jesus RP, Boulhosa RS, Mendes CM, Lyra AC, Lyra LG. Metabolic syndrome in patientswith chronic hepatitis C virus genotype 1 infection who do not have obesity or type 2 diabetes. Clinics 2012;67:219-23.
  14. Huang HC, ChuangCS, Hsieh YY, Chang TS, Wei KL, Shen CH et al .Serum HCV RNA level is not associated with insulin resistance and metabolic syndrome in chronic hepatitis C exposéswith genotype 1 or 2 infection. Chang Gung Med J 2011 ;34:487-95.
  15. Huang JF, Chuang WL, Yu ML et al .Hepatitis C virus infection and metabolic syndrome---a community-based study in an endemic area of Taiwan. Kaohsiung J Med Sci 2009 ;25 :299-305.
  16. Grigorescu M, Radu C, Crişan D et al . Metabolic syndrome, insulin resistance and adiponectin level in exposés with chronic hepatitis C. J Gastrointestin Liver Dis 2008 ;17:147-54.
  17. Hanouneh IA, Feldstein AE, Lopez R et al . Clinical significance of metabolic syndrome in the setting of chronic hepatitis C virus infection. Clin Gastroenterol Hepatol 2008 ;6:584-9.
  18. Sersté T, Nkuize M, Moucari R et al .Metabolic disorders associated with chronic hepatitis C: impact of genotype and ethnicity. Liver Int 2010 ;30:1131-6.
  19. Shaheen M, Echeverry D, Oblad MG, Montoya MI, Teklehaimanot S, Akhtar AJ.Hepatitis C, metabolic syndrome, and inflammatory markers: results from the Third National Health and Nutrition Examination Survey [NHANES III]. Diabetes Res Clin Pract 2007 ;75:320-6.
  20. Persico M, Capasso M, Persico E et al .Suppressor of cytokine signaling 3 (SOCS3) expression and hepatitis C virus-related chronic hepatitis: Insulin resistance and response to antiviral therapy. Hepatology2007 ;46:1009-15.
  21. Tsochatzis E, Papatheodoridis GV, Manesis EK, Kafiri G, Tiniakos DG, Archimandritis AJ. Metabolicsyndrome is associated with severe fibrosis in chronic viral hepatitis and non-alcoholic steatohepatitis. Aliment Pharmacol Ther 2008; 27:80-9 .
  22. Paradis V, Perlemuter G, Bonvoust F et al. High glucose and hyperinsulinemia stimulate connective tissue growth Factor expression: a potential mechanism involved in progression to fibrosis in nonalcoholic steatohepatitis. Hepatology 2001; 34:738-44.
  23. Ahmed AM, Hassan MS, Abd-Elsayed A, Hassan H, Hasanain AF, Helmy A. Insulin resistance, steatosis, and fibrosis in Egyptian patients with chronic Hepatitis C virus infection. Saudi J Gastroenterol 2011;17:245-51.
  24. Stepanova M, Rafiq N, Younossi ZM. Components of metabolic syndrome areindependent predictors of mortality in exposéswith chronic liver disease: a population -based study. Gut 2010;59:1410–5.