Association of insulin resistance, viral load, and adipokine levels with liver histology in patients with chronic hepatitis C: an observational, multicenter study in Turkey

Eur J Gastroenterol Hepatol. 2012 Dec;24(12):1393-9. doi: 10.1097/MEG.0b013e3283585863.


Objective: To evaluate the association of insulin resistance (IR), viral load, and adipokine levels with liver histology in patients with chronic hepatitis C (CHC).

Patients and methods: In this noninterventional, multicenter study carried out at 11 infectious diseases clinics in Turkey, 103 CHC patients [mean (SD) age: 50.2 (11.0) years, 60 (58.3%) women] planned to be treated by ribavirin and peginterferon-α2a were included. Data on hepatic fibrosis and steatosis, IR, viral load, and hepatitis C virus-RNA genotyping, adipokine, and cytokine levels were collected.

Results: The mean (SD) Knodell score was 8.1 (3.6); grade I steatosis was evident in 46 (44.7%) patients and IR was identified in 56 (54.9%). There was a significant positive correlation of the homeostasis model assessment-IR index with Knodell fibrosis (r=0.235; P=0.027) and hepatic steatosis (r=0.435; P<0.001). There was a significant positive correlation of leptin levels with Knodell fibrosis (r=0.265; P=0.013) and hepatic activity index (r=0.218; P=0.041). Hepatic steatosis was correlated negatively with adiponectin (r=-0.320; P=0.001) and positively with leptin (r=-0.368; P<0.001) levels. Logistic regression analysis showed that increase in age [odds ratio (OR), 1.056; 95% confidence interval (CI), 1.005-1.110; P=0.030] was the only significant predictor of hepatic fibrosis (OR, 1.056; 95% CI, 1.005-1.110; P=0.030), whereas increase in age (OR, 1.066; 95% CI, 1.006-1.130; P=0.030), the presence of IR (OR, 5.621; 95% CI, 1.547-20.425; P=0.009), and decrease in adiponectin levels (OR, 0.808; 95% CI, 0.682-0.957; P=0.013) were the significant predictors of hepatic steatosis.

Conclusion: Our findings indicate a significant relationship of hepatic fibrosis and hepatic steatosis with IR and leptin levels, but not with the viral load in Turkish patients with CHC.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipokines / blood*
  • Adult
  • Biomarkers / blood
  • Chi-Square Distribution
  • Fatty Liver* / blood
  • Fatty Liver* / diagnosis
  • Fatty Liver* / epidemiology
  • Fatty Liver* / virology
  • Female
  • Hepacivirus / genetics
  • Hepatitis C, Chronic* / blood
  • Hepatitis C, Chronic* / diagnosis
  • Hepatitis C, Chronic* / epidemiology
  • Humans
  • Insulin Resistance*
  • Liver / pathology*
  • Liver / virology
  • Liver Cirrhosis* / blood
  • Liver Cirrhosis* / diagnosis
  • Liver Cirrhosis* / epidemiology
  • Liver Cirrhosis* / virology
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Predictive Value of Tests
  • RNA, Viral / blood
  • Turkey / epidemiology
  • Viral Load*


  • Adipokines
  • Biomarkers
  • RNA, Viral