Whole-body insulin sensitivity index is a highly specific predictive marker for virological response to peginterferon plus ribavirin therapy in chronic hepatitis C patients with genotype 1b and high viral load.
Insulin resistance is a candidate predictive factor for virological response to peginterferon plus ribavirin (PEG/RBV) therapy in chronic hepatitis C patients. We examined whether indices of insulin resistance could serve as a predictor of sustained virological response (SVR). Fifty-one patients with genotype 1b and high viral load who received PEG/RBV therapy for 48 weeks were included. Homeostasis model assessment of insulin resistance (HOMA-IR) and whole-body insulin sensitivity index (WBISI) calculated from the 75-g oral glucose tolerance test and serum levels of soluble tumor necrosis factor receptor 2 (sTFNR2) were evaluated before therapy. Patients who achieved SVR had significantly lower HOMA-IR and sTNFR2 levels and a higher WBISI compared with non-SVR patients. The positive predictive value for SVR was 0.653 for a HOMA-IR of <2 and 0.846 for a WBISI of 6 or higher. WBISI may serve as a highly specific predictor for SVR in PEG/RBV therapy.
Mizuta
Toshihiko
T
Department of Internal Medicine, Saga Medical School, 5-1-1 Nabeshima, Saga, Japan. mizutat@med.saga-u.ac.jp
Kawaguchi
Yasunori
Y
Eguchi
Yuichiro
Y
Takahashi
Hirokazu
H
Ario
Keisuke
K
Akiyama
Takumi
T
Oza
Noriko
N
Otsuka
Taiga
T
Kuwashiro
Takuya
T
Yoshimura
Toru
T
Hisatomi
Akitaka
A
Ozaki
Iwata
I
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D005951:Glucose Tolerance Test; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000378:metabolism / Q000821:virology; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance; D000078790:Insulin Secretion; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D047889:Receptors, Tumor Necrosis Factor, Type II / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage*; D012680:Sensitivity and Specificity; D019562:Viral Load / Q000187:drug effects
D000998:Antiviral Agents; D007328:Insulin; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D047889:Receptors, Tumor Necrosis Factor, Type II; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b