Effect of interferon treatment on glucose metabolism in children with chronic hepatitis B infection.
OBJECTIVE
Interferon is known to have some effects on glucose metabolism, but this issue has not been investigated in children with chronic hepatitis B infection. The aim of this study was to investigate the impact of interferon on glucose metabolism and to investigate whether autoimmunity has a role in the pathogenesis.


METHODS
Fourteen patients (9 male, 6.3+/-2.7 years) with children with chronic hepatitis B infection were prospectively evaluated. They received interferon 10 MU/m2 for six months. Vral glucose tolerance test, fasting insulin and C-peptide, postprandial insulin and C-peptide, anti-GAD antibody, HOMA-IR and glucose/insulin ratio were measured before and after treatment.


RESULTS
Before interferon, oral glucose tolerance test showed glucose intolerance in two patients (14.5%) and hypoglycemia in one patient (7.1%). One patient had hyperinsulinemia and insulin resistance (7.1%), and four patients had hypoinsulinemia and insulin hypersensitivity (28.5%). After interferon, oral glucose tolerance test was normal in 13 patients (92.8%). Abnormal oral glucose tolerance test persisted in the same patient, but no difference was found in insulin resistance. Hypoinsulinemia and insulin hypersensitivity were present in five patients (35.7%). DM related autoantibodies were negative in all patients before interferon; however, one patient, whose glucose metabolism was within normal limits, developed anti-GAD antibody after interferon.


CONCLUSIONS
Children with children with chronic hepatitis B infection were shown to have hypoinsulinemia and insulin hypersensitivity. These children may have risk of progresssing to insuline dependent drabetes mellitus. We demonstrated that interferon did not seem to worsen glucose metabolism, but it had minimal positive impact on it. These results should be supported with other studies and interferon should be used carefully, especially in children with decreased beta cell reserve.
Kuloğlu
Zarife
Z
Division of Gastroenterology, Department of Pediatrics, School of Medicine, Ankara University, Ankara, Turkey. zarifekuloglu@yahoo.com
Kansu
Aydan
A
Berberoğlu
Merih
M
Demirçeken
Fulya
F
Ocal
Gönül
G
Girgin
Nurten
N
D001786:Blood Glucose / Q000032:analysis; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism*; D005951:Glucose Tolerance Test; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007330:Insulin Antibodies / Q000032:analysis; D007372:Interferons / Q000008:administration & dosage*; D008297:Male; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D001786:Blood Glucose; D007330:Insulin Antibodies; D002097:C-Reactive Protein; D007372:Interferons; D005947:Glucose