title: Effect of sustained virological response to treatment on the incidence of abnormal glucose values in chronic hepatitis C.
abstract: OBJECTIVE
  To investigate the effect of sustained virological response (SVR) on impaired fasting glucose (IFG) and/or type 2 diabetes (T2DM); to assess the influence of glucose abnormalities on the SVR rate.
  
  
  METHODS
  1059 patients with chronic HCV; normal glucose (< 100 mg/dl) in 734, IFG (between 100 and 125 mg/dl) in 218, and T2DM (126 mg/dl) in 107 cases, were treated with interferon plus ribavirin over 24 or 48 weeks, depending on viral genotype.
  
  
  RESULTS
  The SVR rate was lower in patients with IFG and/or T2DM than in patients with normal glucose concentrations [143/325 (44%) vs. 432/734 (58.8%); P=0.002]. In the follow-up, abnormal glucose concentrations were observed in 74 of 304 (24.3%) non-responders and in 49 of 430 (11.4%) sustained responders (log-rank: 13.8; P=0.00002). Reverse stepwise logistic regression analysis identified the independent variables predictive of IFG or T2DM development as: sustained response (OR: 0.44; 95%CI=0.20-0.97; P=0.004) and fibrosis stage (OR: 1.46; 95%CI=1.06-2.01;P=0.02). Family history of DM, steatosis, gender, HCV viral load, genotype, triglycerides, cholesterol and BMI did not enter the multivariate analysis equation.
  
  
  CONCLUSIONS
  SVR reduces the risk of IFG and/or T2DM development in patients with chronic hepatitis C while altered glucose metabolism impairs sustained response to viral treatment.
authors.affiliation: Unit for the Clinical Management of Digestive Diseases and CIBEREHD, Hospital Universitario de Valme, Seville, Spain. mromerog@supercable.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Romero-Gómez
authors.forename: Conrado M
authors.initials: CM
authors.lastname: Fernández-Rodríguez
authors.forename: Raúl J
authors.initials: RJ
authors.lastname: Andrade
authors.forename: Moisés
authors.initials: M
authors.lastname: Diago
authors.forename: Sonia
authors.initials: S
authors.lastname: Alonso
authors.forename: Ramón
authors.initials: R
authors.lastname: Planas
authors.forename: Ricard
authors.initials: R
authors.lastname: Solá
authors.forename: José A
authors.initials: JA
authors.lastname: Pons
authors.forename: Javier
authors.initials: J
authors.lastname: Salmerón
authors.forename: Rafael
authors.initials: R
authors.lastname: Barcena
authors.forename: Ramón
authors.initials: R
authors.lastname: Perez
authors.forename: Isabel
authors.initials: I
authors.lastname: Carmona
authors.forename: Santiago
authors.initials: S
authors.lastname: Durán
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D012254:Ribavirin / Q000008:administration & dosage; D019562:Viral Load
chemical_list: D001786:Blood Glucose; D012254:Ribavirin; D007372:Interferons; D000410:Alanine Transaminase