GC gene polymorphism and unbound serum retinol-binding protein 4 are related to the risk of insulin resistance in patients with chronic hepatitis c: A prospective cross-sectional study

Abstract

Insulin resistance (IR) is found in chronic hepatitis C (CHC) more frequently than in other chronic liver diseases. Prospective cross-sectional study to evaluate a wide multitest panel to identify factors related with IR in CHC and their possible interactions. In 76 patients with CHC we performed a series of routine laboratory analysis as well as specifically designed serum biochemical tests [retinol, retinol-binding protein 4 (RBP4), 25-OH vitamin D, Vitamin E, lipopolysaccharide-binding protein (LBP), interleukin-6 (IL-6), and cystatin C]. The single nucleotide polymorphisms rs7041 and rs4588 GC-DBP (group-specific component-Vitamin D-binding protein), rs738409 PNPLA3 (patatin-like phospholipase domain containing 3), and rs12979860 IL28B (interleukin-28 B) genes were determined. Insulin sensitivity was established with the HOMA-IR and IR was diagnosed when HOMA-IR>3. Fibrosis staging was assessed with liver biopsy or transient elastography. After backward logistic regression analysis, independent variables associated with IR were Gc1s/Gc1s DBP phenotype, that results from the homozygous carriage of the rs7041G/rs4588Chaplotype (P¼0.033); low retinol/RBP4 ratio, reflecting a greater rate of unboundRBP4 (P¼0.005); older age (P¼0.01); high serum tryglicerides (P¼0.026); and advanced (F3–F4) fibrosis stage. The AUROC provided by the multivariate model was 0.950 (95% CI¼0.906–0.993). In addition to previously known ones, the Gc1s/Gc1s phenotype variant of DBP and the unbound fraction of plasma RBP4 may be considered as factors related with the incidence, and possibly the risk, of IR in CHC patients.