PMID- 20714007
OWN - NLM
STAT- MEDLINE
DCOM- 20101213
LR  - 20130516
IS  - 1665-2681 (Print)
IS  - 1665-2681 (Linking)
VI  - 9 Suppl
DP  - 2010
TI  - Insulin resistance, hepatic steatosis and hepatitis C: a complex relationship 
      with relevant clinical implications.
PG  - 112-8
AB  - Insulin resistance (IR) is a common pathophysiological condition where 
      higher-than-normal concentrations of insulin are needed to maintain a normal 
      glycemia and adequate glucose utilization in insulin target tissues. A high 
      proportion (50-80%) of patients chronically infected with the hepatitis C virus 
      (HCV) exhibit evidence of IR. Basic and clinical studies have disclosed a complex 
      bidirectional relationship between IR and HCV infection that has important 
      clinical implications. HCV infection may promote IR through direct 
      viral-dependent mechanisms or due to activation of the inflammatory response 
      resulting in increased production of tumor necrosis factor-a and other 
      cytokine-related molecules. These abnormalities may act synergistically with 
      pre-existing metabolic risk factors and result in the development of hepatic 
      steatosis and type 2 diabetes mellitus (T2DM) which are frequently found in the 
      setting of HCV infection. Moreover, in addition to underlying metabolic 
      abnormalities leading to its development hepatic steatosis also exhibit 
      genotype-specific pathogenic mechanisms. A number of studies have shown that 
      hepatic steatosis is associated to fibrosis progression in patients with HCV and 
      that IR has a negative impact on the response rates to interferon-a-based 
      therapy. Thus, modification of these factors through life-style changes or 
      pharmacological agents may represent an undervalued specific target of therapy 
      aiming to improve sustained virological response rates and reduce HCV 
      related-morbidity and mortality.
FAU - Arrese, Marco
AU  - Arrese M
AD  - School of Medicine, Pontificia Universidad Catolica de Chile, Marcoleta #367, 
      Santiago, Chile. marrese@med.puc.cl
FAU - Riquelme, Arnoldo
AU  - Riquelme A
FAU - Soza, Alejandro
AU  - Soza A
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PL  - Mexico
TA  - Ann Hepatol
JT  - Annals of hepatology
JID - 101155885
RN  - 0 (Antiviral Agents)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Antiviral Agents/therapeutic use
MH  - Energy Intake
MH  - Fatty Liver/epidemiology/metabolism/*physiopathology/therapy
MH  - Hepatitis C/drug therapy/epidemiology/metabolism/*physiopathology
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - *Insulin Resistance
MH  - Risk Reduction Behavior
MH  - Treatment Outcome
MH  - Viral Load
MH  - Weight Loss
EDAT- 2010/08/28 06:00
MHDA- 2010/12/14 06:00
CRDT- 2010/08/18 06:00
PHST- 2010/08/18 06:00 [entrez]
PHST- 2010/08/28 06:00 [pubmed]
PHST- 2010/12/14 06:00 [medline]
AID - 916036 [pii]
PST - ppublish
SO  - Ann Hepatol. 2010;9 Suppl:112-8.