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

초록

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 beta cells (HOMA-beta) 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-beta 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

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