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Casas-Deza D, Espina S, Martínez-Sapiña A, Del Moral-Bergos R, Garcia-Sobreviela MP, Lopez-Yus M, Calmarza P, Bernal-Monterde V, Arbones-Mainar JM. Triglyceride-rich lipoproteins and insulin resistance in patients with chronic hepatitis C receiving direct-acting antivirals. Atherosclerosis 2023; 375:59-66. [PMID: 37245427 DOI: 10.1016/j.atherosclerosis.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/03/2023] [Accepted: 05/03/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND & AIMS Hepatitis C virus (HCV) interferes with carbohydrate and lipid metabolism causing cardiovascular disease and insulin resistance (IR). Direct-acting antivirals (DAAs) are highly effective for the eradication of HCV, with positive effects on metabolic health although paradoxically associated with increased total and LDL-cholesterol. The aims of this study were 1) to characterize dyslipidemia (lipoprotein content, number, and size) in naive HCV-infected individuals and 2) to evaluate the longitudinal association of metabolic changes and lipoparticle characteristics after DAA therapy. METHODS We conducted a prospective study with one-year follow-up. 83 naive outpatients treated with DAAs were included. Those co-infected with HBV or HIV were excluded. IR was analyzed using the HOMA index. Lipoproteins were studied by fast-protein liquid chromatography (FPLC) and Nuclear Magnetic Resonance Spectroscopy (NMR). RESULTS FPLC analysis showed that lipoprotein-borne HCV was only present in the VLDL region most enriched in APOE. There was a lack of association between HOMA and total cholesterol or cholesterol carried by LDL or HDL at baseline. Alternatively, a positive association was found between HOMA and total circulating triglycerides (TG), as well as with TG transported in VLDL, LDL, and HDL. HCV eradication with DAAs resulted in a strong and significant decrease in HOMA (-22%) and HDL-TG (-18%) after one-year follow-up. CONCLUSIONS HCV-dependent lipid abnormalities are associated with IR and DAA therapy can reverse this association. These findings may have potential clinical implications as the HDL-TG trajectory may inform the evolution of glucose tolerance and IR after HCV eradication.
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Affiliation(s)
- Diego Casas-Deza
- Gastroenterology Department, Miguel Servet University Hospital, 50009, Zaragoza, Spain; Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Miguel Servet University Hospital, 50009, Zaragoza, Spain; Instituto de Investigación Sanitaria (IIS) Aragon, 50009, Zaragoza, Spain
| | - Silvia Espina
- Gastroenterology Department, Miguel Servet University Hospital, 50009, Zaragoza, Spain; Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Miguel Servet University Hospital, 50009, Zaragoza, Spain; Instituto de Investigación Sanitaria (IIS) Aragon, 50009, Zaragoza, Spain
| | - Ana Martínez-Sapiña
- Clinical Microbiology Department, Miguel Servet University Hospital, 50009, Zaragoza, Spain
| | - Raquel Del Moral-Bergos
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Miguel Servet University Hospital, 50009, Zaragoza, Spain; Instituto de Investigación Sanitaria (IIS) Aragon, 50009, Zaragoza, Spain; Instituto Aragones de Ciencias de la Salud (IACS), 50009, Zaragoza, Spain
| | - Maria Pilar Garcia-Sobreviela
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Miguel Servet University Hospital, 50009, Zaragoza, Spain; Instituto de Investigación Sanitaria (IIS) Aragon, 50009, Zaragoza, Spain
| | - Marta Lopez-Yus
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Miguel Servet University Hospital, 50009, Zaragoza, Spain; Instituto Aragones de Ciencias de la Salud (IACS), 50009, Zaragoza, Spain
| | - Pilar Calmarza
- Instituto de Investigación Sanitaria (IIS) Aragon, 50009, Zaragoza, Spain; Clinical Biochemistry Department, Miguel Servet University Hospital, 50009, Zaragoza, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), Instituto Salud Carlos III, 28029, Madrid, Spain
| | - Vanesa Bernal-Monterde
- Gastroenterology Department, Miguel Servet University Hospital, 50009, Zaragoza, Spain; Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Miguel Servet University Hospital, 50009, Zaragoza, Spain; Instituto de Investigación Sanitaria (IIS) Aragon, 50009, Zaragoza, Spain.
| | - Jose M Arbones-Mainar
- Adipocyte and Fat Biology Laboratory (AdipoFat), Translational Research Unit, Miguel Servet University Hospital, 50009, Zaragoza, Spain; Instituto de Investigación Sanitaria (IIS) Aragon, 50009, Zaragoza, Spain; Instituto Aragones de Ciencias de la Salud (IACS), 50009, Zaragoza, Spain; CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, 28029, Madrid, Spain.
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