Relationship between Fasting Insulin Concentration as a Risk Factor for Cardiovascular Disease and High-Density Lipoprotein Cholesterol Levels in Patients with Chronic Hepatitis C

Abstract

The objective of this study was to evaluate the association between fasting insulin concentration—as a cardiovascular risk factor—and the high density lipoprotein level (HDL-c) in patients with chronic hepatitis C. Material and Methods: In this cross-sectional study, were included 171 patients from Bucharest, to which were followed anthropometric indexes. Biochemical parameters followed were glucose fasting insulin, glycosylated hemoglobin, lipid profile, liver profile, blood counts. The 10-year coronary heart disease (CHD) was calculated for each patient using the UKPDS risk engine. Results: The mean age of patients was evaluated 53.14 ± 8.3 years, females representing 53.8% (n=92) of total. Using the UKPDS score 24% (n=41) and 20.5% (n=44) presented moderate and high risk of cardiovascular disease. Levels of fasting insulinemia was significantly high in patients with increase (12.2 uUI/ml) and moderate risk (16.4 uUI/ml) of cardiovascular disease (p<0.001). Level of HDL-cholesterol was significantly lower in patients with increase cardiovascular risk (34.41 mg/dl) vs. patients with reduce (43.03 mg/dl) or moderate cardiovascular risk (39.59 mg/dl) (p<0.001). UKPDS score was positively correlated with age (r=0.62, p=0.001), Forns index (r=0.55, p=0.001), BMI (r=0.39, p=0.001), smoking status (r=0.52, p=0.001), HbA1c (r=0.41, p=0.001), triglycerides (r=0.43, p=0.001), LDL-c (r=0.43, p=0.001), AST (r=0.33, p=0.001), ALT (r=0.26, p=0.001) and GGT (r=0.31, p=0.001) and negative with HDL-c (r=-0.44, p=0.001) and albumin (r=-0.29, p=0.001). Conclusions: A higher fasting insulin concentration or hyperinsulinemia was significantly associated with an increased cardiovascular risk. This study suggests that early fasting insulin ascertainment in the patients with HCV may help clinicians identify those who are potentially at high risk of CVD. Disclosure R. Dragut: None. E. Rusu: None. R. Cursaru: None. F. Rusu: None. A. Cursaru: None. H. Popescu: None. G. Radulian: None.