Clinical—Liver, Pancreas, and Biliary TractChronic Hepatitis C Is Associated With Peripheral Rather Than Hepatic Insulin Resistance
Section snippets
Materials and Methods
See additional information regarding methods in the Supplementary Materials and Methods.
Baseline Characteristics of Subjects
CHC subjects (n = 29) and controls (n = 15) were selected to be matched for age, weight, BMI, and were similar for abdominal fat (visceral and subcutaneous fat). There was a higher frequency of smokers and methadone users in CHC subjects (Table 1). Among CHC subjects, methadone users and smokers, compared to nonusers, had similar baseline characteristics except for higher waist-to-hip ratios (P = .04) in methadone users and higher highly sensitive C-reactive protein (P = .02) and low-density
Discussion
This study demonstrates that nonobese male subjects with CHC and mild liver disease had significant IR compared to healthy controls of similar age, BMI, and physical activity and that this IR is principally in the periphery, contrasting with previous suggestions of impaired hepatic insulin action,33 although there may be a small contribution from the liver. This observation is supported by the decreased insulin stimulated glucose disposal at high insulin dose clamp (when endogenous glucose
Acknowledgments
Drs George and Chisholm contributed equally to this work and are joint senior authors.
Clinical trials registry no: NCT00707603.
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Conflicts of interest The authors disclose no conflicts.
Funding Supported by grants from the National Health and Medical Research Council of Australia (Grant 358398), GESA postgraduate medical research scholarship, Robert W. Storr Bequest to the University of Sydney, a University of Sydney Grant and Hong Kong Research Council CRF (HKU 2/07C to A.X.). K.M. is supported by a National Health and Medical Research Council Postgraduate scholarship. M.T. is supported by a Diabetes UK RD Lawrence Fellowship.