The aim of the study was to evaluate the relationship between metabolic disorders and polymorphic variants of the genes encoding for beta-2-adrenergic receptor (ADRB2 (rs1042713) and apolipoproteins B (ApoB(rs5742904) in patients with chronic hepatitis C (CHC) depending on virus genotype and in patients with non-alcoholic fatty liver diseases (NAFLD) and concomitant metabolic syndrome (MS).
Materials and methods: The study included 96 patients with CHC (51 with genotype 1 or 2 of hepatitis virus and 45 with genotype 3), 70 patients with NAFLD and MS, 51 healthy donors (controls). Gene polymorphism was studied by PCR (Sintol, Moscow) with a Real-time CFX-96 amplifier (Bio-Rad Lab. Inc., USA).
Results: CHC patients regardless of genotype had hypertriglyceridemia with increased atherogenicity index and C-peptide level. Hyperleptinemia was most frequently associated with genotype 3, hyperinsulinemia and insulin resistance with genotypes 1 and 2. The viremia level positively correlated with leptin level (p-0.021) and HOMA-IR index (p=0.022) which suggests virus-induced inactivation of mechanisms of steatogenesis and insulin resistance. Leptin production in CHC was associate with activation of liver fibrosis as appears from elasticity index measured by fibroelastography (p-0.22). Almost all patients with NAFLD had disturbances of lipid and carbohydrate metabolism. Hepatic lesions in 30% of the patients with MS were accompanied by laboratory signs of steatohepatitis. Patients with CHC showed an increased frequency of minor A allele of the ADRB2 (rs1042713) gene (up to 40%; p=0.04) and pathological A/A homozygote (22%; p=0.04). The occurrence of A allele was associated with hyperleptinemia (p=0.019). In NAFLD patients, the occurrence of A allele was higher than in controls (41%; p=0.02) with 55% of the case being A/G heterozygotes (p=0.005). The occurrence of A allele was related to hyperinsilinism (p=0.036), BMI (p=0.0330, and C-peptide production (p=0.038). No difference between the frequency of genotypes and ApoB(rs5742904) gene alleles in the patients of both groups and controls was documented. It is concluded that ADRB2 (rs1042713) gene polymorphism is associated with an increased risk of metabolic disorders in CHC and especially NAFLD with MS that aggravates liver disturbances. Dyslipidemia and insulin resistance in CHC patients is stimulated by viral infection.