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The impact of pegylated interferon and ribavirin combination treatment on lipid metabolism and insulin resistance in chronic hepatitis C patients

이윤나|장재영|정승원|이세환|김홍수|김부성|김영석|김상균|정희재
대한간학회 (The korean Association for the Study of the Liver)|2014.03|Clinical and Molecular Hepatology|제20권 제1호|pp. 38-46|DOI http://dx.doi.org/10.3350/cmh.2014.20.1.38

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키워드

Lipid metabolismInsulin resistanceChronic hepatitis C

초록

Background/Aims: Lipid profile and insulin resistance (IR) are associated with hepatitis C virus (HCV) and may predictthe chronic hepatitis C (CHC) treatment response. The aim of this study was to determine the association betweenCHC 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 atSoon 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 whompossessed genotype 1, with the remainder being non-genotype-1 (40%, n=24). Apart from age, which wassignificantly higher in the non-SVR group (SVR, 48.0±11.2 years, mean±SD; non-SVR, 56.6±9.9 years; P<0.01), therewere 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 insulinresistance (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 HCVmay improve whole-body IR and insulin hypersecretion, as well as high baseline insulin resistance (HOMA-IR >2.5).

Abstract

Background/Aims: Lipid profile and insulin resistance (IR) are associated with hepatitis C virus (HCV) and may predictthe chronic hepatitis C (CHC) treatment response. The aim of this study was to determine the association betweenCHC 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 atSoon 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 whompossessed genotype 1, with the remainder being non-genotype-1 (40%, n=24). Apart from age, which wassignificantly higher in the non-SVR group (SVR, 48.0±11.2 years, mean±SD; non-SVR, 56.6±9.9 years; P<0.01), therewere 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 insulinresistance (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 HCVmay improve whole-body IR and insulin hypersecretion, as well as high baseline insulin resistance (HOMA-IR >2.5).

참고문헌 (33)

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