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, 20 (1), 38-46

The Impact of Pegylated Interferon and Ribavirin Combination Treatment on Lipid Metabolism and Insulin Resistance in Chronic Hepatitis C Patients

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The Impact of Pegylated Interferon and Ribavirin Combination Treatment on Lipid Metabolism and Insulin Resistance in Chronic Hepatitis C Patients

Hee Jae Jung et al. Clin Mol Hepatol.

Abstract

Background/aims: Lipid profile and insulin resistance (IR) are associated with hepatitis C virus (HCV) and may predict the chronic hepatitis C (CHC) treatment response. The aim of this study was to determine the association between CHC treatment response and lipid profile and IR change during treatment.

Methods: In total, 203 CHC patients were reviewed retrospectively between January 2005 and December 2011 at Soon Chun Hyang University Hospital. The lipid profile, homeostasis model for assessment (HOMA) of IR (HOMA-IR), and HOMA of β cells (HOMA-β) were evaluated before interferon plus ribavirin therapy (BTx), at the end of treatment (DTx), and 24 weeks after the end of treatment (ATx).

Results: A sustained virologic response (SVR) was achieved by 81% of all patients (49/60), 60% (n=36) of whom possessed genotype 1, with the remainder being non-genotype-1 (40%, n=24). Apart from age, which was significantly higher in the non-SVR group (SVR, 48.0 ± 11.2 years, mean ± SD; non-SVR, 56.6 ± 9.9 years; P<0.01), there were no significant differences in the baseline characteristics between the SVR and non-SVR groups. In the SVR group, low density lipoprotein-cholesterol (LDL-C) had significantly changed at DTx and ATx compared to BTx. In addition, HOMA-IR and HOMA-β were significantly changed at DTx in the SVR group. Among those with a high baseline insulin resistance (HOMA-IR >2.5), HOMA-IR was significantly changed at DTx in the SVR group.

Conclusions: LDL-C appears to be associated with HCV treatment in SVR patients. Furthermore, eradication of HCV may improve whole-body IR and insulin hypersecretion, as well as high baseline insulin resistance (HOMA-IR >2.5).

Keywords: Chronic hepatitis C; Insulin resistance; Lipid metabolism.

Conflict of interest statement

The authors have no conflicts to disclose.

Figures

Figure 1
Figure 1
Changes in total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels in hepatitis C virus (HCV)-positive patients according treatment efficacy (★statistically significant differences during treatment in the sustained virologic response, SVR, group, P<0.05). LDL-C had significantly changed at DTX and ATx compared to BTx. TC, total cholesterol; TG, triglyceride; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; SVR, sustained virologic response; BTx, Before treatment; DTx, End of treatment; ATx, After treatment.
Figure 2
Figure 2
Sequential changes in homeostasis model assessment (HOMA) of β cells (HOMA-β) and HOMA of insulin resistance (HOMA-IR) in all patients receiving pegylated interferon plus ribavirin combination therapy, relative to treatment response. HOMA-IR and HOMA-β were significantly changed at DTx in the SVR group. HOMA-β, homeostasis model assessment of β cell; HOMA-IR, homeostasis model assessment of insulin resistance; SVR, sustained virologic response; BTx, Before treatment; DTx, End of treatment; ATx, After treatment.
Figure 3
Figure 3
Sequential changes in HOMA-β and HOMA-IR in patients with a high baseline HOMA-IR receiving pegylated interferon plus ribavirin combination therapy, relative to treatment response (★statistically significant differences during treatment in the SVR group, P<0.05). In high baseline insulin resistance (HOMA-IR>2.5), HOMA-IR was significantly changed at DTx in the SVR group. HOMA-β, homeostasis model assessment of β cell; HOMA-IR, homeostasis model assessment of insulin resistance; SVR, sustained virologic response; BTx, Before treatment; DTx, End of treatment; ATx, After treatment.

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