Evidence mapPaperPMID 30586166Full record

ArticleClinical endocrinology2019

Hepatitis C virus infection is associated with hepatic and adipose tissue insulin resistance that improves after viral cure.

Teegan R Lim, Jonathan M Hazlehurst, Andrei I Oprescu, Matthew J Armstrong, Sewa F Abdullah, Nigel P Davies, Robert Flintham, Peter Balfe, David J Mutimer, Jane A McKeating and 1 more

Open access · hybridAbstract read
In one paragraph

Article in Clinical endocrinology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.7field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 22 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Article
  6. Metabolic complications of hepatitis C virus infection.World journal of gastroenterology · 2021
    Review
  7. Article
  8. Rewiring Host Signaling: Hepatitis C Virus in Liver Pathogenesis.Cold Spring Harbor perspectives in medicine · 2020
    Review
  9. Article
  10. Metabolic Syndrome in HIV/HCV Co-infected Patients.Current treatment options in infectious diseases · 2019
    Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Teegan R LimNIHR Liver Biomedical Research Unit, University of Birmingham, Birmingham, UK.
Jonathan M HazlehurstInstitute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
Andrei I OprescuNIHR Liver Biomedical Research Unit, University of Birmingham, Birmingham, UK.
Matthew J ArmstrongNIHR Liver Biomedical Research Unit, University of Birmingham, Birmingham, UK.
Sewa F AbdullahSchool of Sport, Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Nigel P DaviesMedical Physics, University Hospitals Birmingham, Birmingham, UK.
Robert FlinthamMedical Physics, University Hospitals Birmingham, Birmingham, UK.ORCID 0000-0002-1842-2653
Peter BalfeNIHR Liver Biomedical Research Unit, University of Birmingham, Birmingham, UK.
David J MutimerNIHR Liver Biomedical Research Unit, University of Birmingham, Birmingham, UK.
Jane A McKeatingNuffield Department of Medicine, University of Oxford, Oxford, UK.
Jeremy W TomlinsonOxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, UK.
NIHR Birmingham Liver Biomedical Research Unit · GBNIHR Surgical Reconstruction and Microbiology Research Centre · GBUniversity of Birmingham · GBUniversity of Oxford · GB

Funding

Department of HealthMedical Research Council G0801976Medical Research Council G1100247Medical Research Council MC_PC_16056Medical Research Council MR/K01532X/1Medical Research Council MR/P011462/1Wellcome Trust 200838/Z/16/Z
6 · The paper itself

Abstract

backgroundChronic hepatitis C (CHC) is associated with systemic insulin resistance, yet there are limited data on the tissue-specific contribution in vivo to this adverse metabolic phenotype, and the effect of HCV cure.

methodsWe examined tissue-specific insulin sensitivity in a cohort study involving 13 patients with CHC compared to 12 BMI-matched healthy control subjects. All subjects underwent a two-step clamp incorporating the use of stable isotopes to measure carbohydrate and lipid flux (hepatic and global insulin sensitivity) with concomitant subcutaneous adipose tissue microdialysis and biopsy (subcutaneous adipose tissue insulin sensitivity). Investigations were repeated in seven patients with CHC following antiviral therapy with a documented sustained virological response.

resultsAdipose tissue was more insulin resistant in patients with CHC compared to healthy controls, as evidence by elevated glycerol production rate and impaired insulin-mediated suppression of both circulating nonesterified fatty acids (NEFA) and adipose interstitial fluid glycerol release during the hyperinsulinaemic euglycaemic clamp. Hepatic and muscle insulin sensitivity were similar between patients with CHC and controls. Following viral eradication, hepatic insulin sensitivity improved as demonstrated by a reduction in endogenous glucose production rate. In addition, circulating NEFA decreased with sustained virological response (SVR) and insulin was more effective at suppressing adipose tissue interstitial glycerol release with a parallel increase in the expression of insulin signalling cascade genes in adipose tissue consistent with enhanced adipose tissue insulin sensitivity.

conclusionChronic hepatitis C patients have profound subcutaneous adipose tissue insulin resistance in comparison with BMI-matched controls. For the first time, we have demonstrated that viral eradication improves global, hepatic and adipose tissue insulin sensitivity.

Indexed as

Insulin ResistanceAdipose TissueAdultAntiviral AgentsBlood GlucoseCase-Control StudiesFemaleHepatitis C, ChronicHumansLipid MetabolismLiverMaleMiddle AgedYoung AdultAntiviral AgentsBlood Glucoseadipose tissueHCVhepaticinsulin resistance

Identifiers

PMID30586166
PMCPMC6446809
OpenAlexW2905674797

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.