Associations of chronic hepatitis C with metabolic and cardiac outcomes

Aliment Pharmacol Ther. 2013 Mar;37(6):647-52. doi: 10.1111/apt.12234. Epub 2013 Feb 5.

Abstract

Background: Chronic hepatitis C virus (CH-C) infection is associated with metabolic conditions such as insulin resistance and type 2 diabetes (DM) and may increase the risk of cardiovascular diseases.

Aim: To assess the association of CH-C with risk factors for cardiovascular diseases using US population data.

Methods: The National Health and Nutrition Examination Surveys (NHANES) collected between 1999 and 2010 were used.

Results: Of 19 741 participants considered eligible for the study. Of this cohort, 173 individuals (0.88%) had detectable HCV RNA and were considered to have CH-C. Compared with controls, CH-C patients were predominantly African American (23.5% vs. 10.5%, P < 0.0001), men (66.6% vs. 46.1%, P = 0.0001), more likely to be between 45 and 55 years of age (41.9% vs. 20.4%, P = 0.0001), had higher rate of insulin resistance (44.1% vs. 31.1%, P = 0.0301), hypertension (40.1% vs. 28.9%, P = 0.0201), and history of smoking (76.2% vs. 29.9%, P < 0.0001). In multivariate analysis, in addition to known risk factors for insulin resistance, CH-C was independently associated with the presence of insulin resistance [OR (95% CI) = 2.06 (1.19-3.57)], DM [OR = 2.31 (1.18-4.54)] and hypertension [OR = 2.06 (1.30-3.24)]. Independent predictors of cardiovascular diseases included older age, presence of obesity and smoking. CH-C was independently associated with congestive heart failure subtype of cardiovascular diseases but not ischaemic heart disease and stroke.

Conclusion: Chronic hepatitis C virus infection is independently associated with presence of metabolic conditions (insulin resistance, type 2 diabetes mellitus and hypertension) and congestive heart failure.

MeSH terms

  • Adult
  • African Americans
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / complications*
  • Diabetes Mellitus, Type 2 / complications*
  • European Continental Ancestry Group
  • Female
  • Hepatitis C, Chronic / complications*
  • Hispanic Americans
  • Humans
  • Insulin Resistance
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Nutrition Surveys