Open Access Research article

PNPLA 3 I148M genetic variant associates with insulin resistance and baseline viral load in HCV genotype 2 but not in genotype 3 infection

Karolina Rembeck1, Cristina Maglio2, Martin Lagging1, Peer Brehm Christensen3, Martti Färkkilä4, Nina Langeland5, Mads Rauning Buhl6, Court Pedersen3, Kristine Mørch5, Gunnar Norkrans1, Kristoffer Hellstrand1, Magnus Lindh1, Carlo Pirazzi2, Maria Antonella Burza2, Stefano Romeo2*, Johan Westin1* and for the NORDynamIC group

Author affiliations

1 Department of Infectious Diseases/Virology, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden

2 Department of Molecular and Clinical Medicine and Center for Cardiovascular and Metabolic Research, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

3 Department of Infectious Diseases, University of Southern Denmark, Odense, Denmark

4 Department of Gastroenterology, Helsinki University, Helsinki, Finland

5 Department of Medicine, Haukeland University Hospital and Institute of Medicine, University of Bergen, Bergen, Norway

6 Department of Infectious Diseases, Aarhus University, Aarhus, Denmark

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Citation and License

BMC Medical Genetics 2012, 13:82  doi:10.1186/1471-2350-13-82

Published: 14 September 2012



Hepatic steatosis in HCV patients has been postulated as a risk factor associated with a higher frequency of fibrosis and cirrhosis. A single genetic variant, PNPLA3 I148M, has been widely associated with increased hepatic steatosis. Previous studies of the PNPLA3 I148M sequence variant in HCV infected individuals have reported an association between this variant and prevalence of steatosis, fibrosis, and cirrhosis. To evaluate the impact of PNPLA3 I148M variant on metabolic traits and treatment response in HCV genotype 2 and 3 infected patients.


Three hundred and eighty-two treatment naïve HCV genotype 2 or 3 infected patients were included in a phase III, open label, randomized, multicenter, investigator-initiated trial (the NORDynamIC study), in which pretreatment liver biopsies were mandatory. PNPLA3I148M genotyping was performed in a total of 359 Caucasian patients.


In HCV genotype 2 infected patients carrying the PNPLA3 148M allele, there was significantly increased insulin resistance (P = 0.023) and lower viral load (P = 0.005) at baseline as well as the first seven days of antiviral treatment. These results were not observed in HCV genotype 3 infected patients.


Our results suggest a possible association between the PNPLA3 148M allele and insulin resistance as well as baseline viral load in HCV genotype 2, but not in genotype 3.

Hepatitis C; PNPLA 3; Insulin resistance; Viral load