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Women with HCV postmenopause may experience insulin resistance

Researchers from the University of California San Francisco found that women with hepatitis C virus infection postmenopause may be at increased risk for insulin resistance and development of metabolic syndrome.

“Given that both menopausal status and [insulin resistance] are associated with negative liver disease clinical outcomes, understanding the relationship between menopausal status and metabolic abnormalities is critical to HCV management,” the researchers wrote. “This information will help to better identify at-risk individuals for targeted interventions to prevent liver disease progressions and those who would most benefit from costly but highly effective anti-HCV therapies.”

To determine the impact of menopause on insulin resistance (IR) and metabolic syndrome in HCV, 103 adults with HCV without cirrhosis or diabetes underwent IR measurement via steady-state plasma glucose during an insulin suppression test. Of the patients, 69 were men, 16 were premenopausal and 18 postmenopausal women.

Overall, steady-state plasma glucose was higher in postmenopausal women compared with premenopausal women or men (mean difference = 18; 95% CI, – 41-76 mg/dL vs. mean difference = 35; 95% CI, − 3-72 mg/dL). After adjusting for waist circumference, researchers found positive associations between female gender, nonwhite race and triglycerides, as well as found a negative association between high-density lipoprotein and steady-state plasma glucose.

Pre- and postmenopausal women had higher steady-state plasma glucose compared with men (Coef 48, 95% CI, 12-84 vs. Coef 49, 95% CI, 17-82). Men (OR = 2.; 95% CI, 0.38-10.2) and postmenopausal women (OR = 2.9; 95% CI, 0.46-18.8) had increased odds of metabolic syndrome compared with pre-menopausal women. However, this was not statistically significant.

Further analyses showed that liver inflammation (OR = 7.9; 95% CI, 1.5-43.2) and nonwhite race (OR = 6.9; 95% CI, 1.5-32) were associated with metabolic syndrome.

“We conclude that women are at increased risk for IR in HCV,” the researchers concluded. “There may also be an increased risk of metabolic syndrome postmenopause. Along with lifestyle modification and weight loss, women with metabolic abnormalities represent an especially at-risk group warranting HCV treatment to prevent adverse metabolic outcomes.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.