NAFLD shares many overlapping features with the insulin resistance syndrome, also known as "Syndrome X" including central or visceral obesity, type II diabetes, and dyslipidemia. Of course, NAFLD is now recognized as a hepatic manifestation of insulin resistance syndrome.
Insulin resistance prevalence is very high among patients with NASH (60-85%). In fact it is pathophysiologically implicated in NAFLD in most of patients. None less, not all patients with NASH have insulin resistance. In the other hand, insulin resistance and DM are detected in 17 – 35% of patients with chronic hepatitis C. The mechanisms by which HCV produces insulin resistance and DM are not clearly known. It was observed that HCV induces insulin resistance regardless of body mass index and fibrosis stage. In a study conducted in a transgenic animal model, the HCV core protein was able to induce insulin resistance, steatosis and DM. In addition, insulin resistance induces antiviral treatment resistance in HCV patients and it is associated to in increments of mortality. I attached one publication that can be of help in this field.
Liver cirrhosis and diabetes: Risk factors, pathophysiology,clinical implications and management. World J Gastroenterol 2009;15:280.
Insulin resistance is almost universal in NASH, it is probably lower in hep C, however I dont know exact data. However we have published a paper on metabolic syndrome and hepatitis B, which could help you a bit.
http://www.ncbi.nlm.nih.gov/pubmed/24445023
Insulin resistance prevalence is very high among patients with NASH (60-85%). In fact it is pathophysiologically implicated in NAFLD in most of patients. None less, not all patients with NASH have insulin resistance. In the other hand, insulin resistance and DM are detected in 17 – 35% of patients with chronic hepatitis C. The mechanisms by which HCV produces insulin resistance and DM are not clearly known. It was observed that HCV induces insulin resistance regardless of body mass index and fibrosis stage. In a study conducted in a transgenic animal model, the HCV core protein was able to induce insulin resistance, steatosis and DM. In addition, insulin resistance induces antiviral treatment resistance in HCV patients and it is associated to in increments of mortality. I attached one publication that can be of help in this field.
Liver cirrhosis and diabetes: Risk factors, pathophysiology,clinical implications and management. World J Gastroenterol 2009;15:280.
"Of course, NAFLD is now recognized as a hepatic manifestation of insulin resistance syndrome". Often we may observe liver steatosis in patients with HCV infection without methabolic syndrome. A study reporting the association of hepatitis C and type II diabetes has been performed in our area:
Am J Gastroenterol. 2013 Jul;108(7):1108-11. doi: 10.1038/ajg.2013.90.
Virus C hepatitis and type 2 diabetes: a cohort study in southern Italy.
Montenegro L1, De Michina A, Misciagna G, Guerra V, Di Leo A.
1/ NASH is a syndrom, Insulin resistance is one of its symptoms
2/ most HCV infections are without significant liver damage, there is no insulin resistance. For those with liver damage, the prevalence of liver damage increases with the level of damage. insulin resistance is frequent in cirrrhosis wathever the cause is.
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