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Background and Aim Chronic hepatitis C virus ( HCV) infection has been suggested to be associated with non-insulin-dependent diabetes mellitus and lipid profiles. This study aimed to investigate the possible relationships of insulin resistance ( IR) and lipid profiles with chronic hepatitis C ( CHC) patients in Taiwan. Methods We enrolled 160 hospital-based CHC patients with liver biopsy and the 480 controlled individuals without CHC and chronic hepatitis B from communities without known history of non-insulin-dependent diabetes mellitus. Fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol ( HDL- C), low-density lipoprotein cholesterol ( LDL- C), triglycerides ( TGs), alanine aminotransferase, and serum insulin levels, and homeostasis model assessment ( HOMA-IR) were tested. Results When comparing factors between CHC patients, and sex- and age-matched controls who had no HCV infection, patients with HCV infection had a significantly higher alanine aminotransferase level, fasting plasma glucose level, insulin level, and HOMA-IR ( P < 0.001, P = 0.023, P = 0.017, and P = 0.011, respectively), and significantly lower TG level ( P = 0.023), total cholesterol, and HDL- C and LDL- C levels (all P < 0.001) than 480 controls. In multivariate logistic regression analyses, a low total cholesterol, a low TGs, and a high HOMA-IR are independent factors significantly associated with chronic HCV infection. In the 160 CHC patients (41 patients with high HOMA-IR [> 2.5]), a high body mass index, TGs, and HCV RNA level are independent factors significantly associated with high HOMA-IR in multivariate logistic analyses. Conclusions Chronic HCV infection was associated with metabolic characteristics including IR and lipid profile. IR was also associated with virological characteristics. [ABSTRACT FROM AUTHOR]