胰岛素抵抗是HCV感染的特殊表现
Insulin resistance tied to hepatitis C infection胰岛素抵抗与丙肝感染
NEW YORK (Reuters Health) - Insulin resistance, a \"prediabetic\" abnormality of blood sugar, is a specific feature of chronic hepatitis C virus (HCV) infection, independent of the severity of HCV or the presence of other metabolic factors, French investigators report.
纽约（路透社健康）-法国研究者报导，一种糖尿病前期的血糖异常：胰岛素抵抗，是慢性丙型肝炎（HCV）感染的一种特殊特征，且不依赖于HCV的严重程度或者是否合并其它的代谢因素。
HCV infection is now recognized as a system-wide disease, Dr. Rami Moucari, of Universite Denis Diderot-Paris, and colleagues note in a report in the journal Gastroenterology. Some previous studies have linked HCV infection to an increased risk of insulin resistance or full-blown diabetes.
目前认为HCV感染是一种系统性疾病，巴黎Denis Diderot大学的Rami Moucari博士和他的同事们在《Gastroenterology》上的一篇文献报导，一些前期的研究已经认为HCV感染与胰岛素抵抗的风险增加和糖尿病的发展相关。
Insulin is the body's key blood sugar-regulating hormone. Normally, insulin is secreted to clear glucose (sugar) from the blood and deposit into cells to use as fuel. Insulin resistance occurs when cells become desensitized to insulin.
胰岛素是体内关键的血糖调节激素。正常情况下，胰岛素的分泌会导致血液中葡萄糖（血糖）的降低，而进入细胞中降解为机体提供能量。当细胞对胰岛素不敏感的时候就发生了胰岛素抵抗。
In their study, Moucari's team found that 150 (32.4 percent) of 462 chronic HCV patients who did not have diabetes were insulin resistant. In this group, insulin resistance was associated with the metabolic syndrome (a cluster of heart disease and diabetes risk factors), as well as HCV genotypes 1 and 4, significant liver scarring or \"fibrosis,\" severe fatty liver disease, and being older than age 40.
Moucari的科研小组发现，在他们的研究中，462个慢性HCV病人中有150个（32.4%）未患糖尿病者亦有胰岛素抵抗。在这群人中，胰岛素抵抗与代谢综合征（一群心脏疾病和糖尿病的危险因素），HCV基因型1和4，显著的肝脏瘢痕化或纤维化，严重的脂肪肝，和年龄大于40岁相关。
Among 145 chronically HCV infected patients without metabolic syndrome or significant fibrosis, insulin resistance was diagnosed in 22 (15 percent). Insulin resistance in this population was also associated with infection with HCV genotypes 1 and 4, high blood levels of HCV, and moderate-to-severe liver inflammation.
在145个没有代谢综合征或者显著的肝纤维化的慢性HCV感染病人中，有22人被诊断为胰岛素抵抗（15%）。这些人群中的胰岛素抵抗被认为与HCV基因型1和4型的感染，血液中的高HCV水平，和中等到严重的肝脏炎症相关。
\"Insulin resistance should be assessed in the routine management of patients with chronic hepatitis C,\" Moucari noted in an interview with Reuters Health.
\"胰岛素抵抗检查应该被作为慢性丙肝病人的常规处理\",Moucari在接受路透社的采访时说。
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搜了一下文中所说的发表在Gastroenterology的那篇文章，一并贴出。
Insulin resistance in chronic hepatitis C: association with genotypes 1 and 4, serum HCV RNA level, and liver fibrosis.
Gastroenterology. 2008 Feb;134(2):416-23. Epub 2007 Nov 12.
BACKGROUND & AIMS: Our study was designed to test the association between insulin resistance (IR) and hepatitis C virus (HCV) genotypes, serum HCV RNA level and liver fibrosis stage in a large prospective cohort of chronic hepatitis C (CHC) patients. METHODS: Six hundred consecutive patients (CHC, n = 500; chronic hepatitis B (CH, n = 100) were evaluated on the day of liver biopsy. IR (Homeostasis Model for Assessment of Insulin Resistance) and all components of the metabolic syndrome were assessed. By logistic regression, independent factors associated with IR and those associated with significant fibrosis were assessed in nondiabetic and noncirrhotic CHC, respectively. Parameters of IR were compared between hepatitis B and 240 CHC matched by epidemiologic, metabolic, and histologic features. RESULTS: IR was present in 32.4% of the 462 nondiabetic CHC and associated with the metabolic syndrome, genotypes 1 and 4, significant fibrosis, and severe steatosis. IR was diagnosed in 15% of 145 CHC without metabolic syndrome or significant fibrosis, and associated with genotypes 1 and 4, high serum HCV RNA level, and moderate-severe necroinflammation. Significant fibrosis was present in 51.1% of the 454 noncirrhotic CHC patients and associated with male sex, age >40 years, IR, moderate-severe necroinflammation, and severe steatosis. IR was less frequent in CHB than in matched CHC (5% vs 35%, respectively, P < .001). CONCLUSIONS: IR is a specific feature of CHC, associated with genotypes 1 and 4 and high serum HCV RNA level. Significant fibrosis is associated with IR independent from steatosis.
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