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Volume 138, Issue 3, Pages e3 (March 2010)

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1 Volume 138, Issue 3, Pages 932-941.e3 (March 2010)
Chronic Hepatitis C Is Associated With Peripheral Rather Than Hepatic Insulin Resistance  Kerry–Lee Milner, David van der Poorten, Michael Trenell, Arthur B. Jenkins, Aimin Xu, George Smythe, Gregory J. Dore, Amany Zekry, Martin Weltman, Vincent Fragomeli, Jacob George, Donald J. Chisholm  Gastroenterology  Volume 138, Issue 3, Pages e3 (March 2010) DOI: /j.gastro Copyright © 2010 AGA Institute Terms and Conditions

2 Figure 1 Mean (± standard error) serum concentrations of insulin (A) and glucose (B) during an intravenous tolerance test between hepatitis C subjects and controls. *P < .05; †P < .01; ‡Data log transformed (Ln) prior to analysis. Gastroenterology  , e3DOI: ( /j.gastro ) Copyright © 2010 AGA Institute Terms and Conditions

3 Figure 2 Mean (± standard error) endogenous glucose production (A) and exogenous glucose infusion rate (M value and M value/insulin levels) (B) during hyperinsulinemic-euglycemic clamp study in hepatitis C subjects and controls and genotype 1 and 3. *P < .001; **These have been log transformed (Ln) prior to analysis. EGP data presented in 11 controls and 27 CHC subjects. M value at low-dose insulin presented in 14 controls and 29 CHC subjects, M value at high-dose insulin presented in 15 controls and 29 CHC subjects. P = .25 (NS) for % suppression EGP in controls vs chronic hepatitis C subjects. Basal EGP significantly lower in hepatitis C subjects compared to controls (P = .04), but not significantly different at low-dose insulin clamp (P = .85). EGP at high-dose insulin not shown as was not significantly different from zero in all groups. Gastroenterology  , e3DOI: ( /j.gastro ) Copyright © 2010 AGA Institute Terms and Conditions

4 Figure 3 Mean (± standard error) serum glucagon (A) and nonesterified free fatty acids (NEFA) (B) levels during hyperinsulinemic-euglycemic clamp in hepatitis C subjects and controls. *P < .05; †P < .01; ‡Data log transformed (Ln) prior to analysis. Gastroenterology  , e3DOI: ( /j.gastro ) Copyright © 2010 AGA Institute Terms and Conditions

5 Figure 4 Correlation of insulin resistance (M value − high-dose insulin) with hepatitis C viral load and subcutaneous fat (both log transformed) in hepatitis C subjects. Results not adjusted for smoking and methadone use. For adjusted analyses, see Table 2. Gastroenterology  , e3DOI: ( /j.gastro ) Copyright © 2010 AGA Institute Terms and Conditions

6 Figure 5 Liver (A) and muscle (intramyocellular [IMCL]) (B) fat in controls, genotype 1 and 3 subjects. Data expressed as mean ± standard error and log transformed (Ln) prior to analysis. Gastroenterology  , e3DOI: ( /j.gastro ) Copyright © 2010 AGA Institute Terms and Conditions


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