title: 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.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Saga Medical School, 5-1-1 Nabeshima, Saga, Japan. mizutat@med.saga-u.ac.jp
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mizuta
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Kawaguchi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Keisuke
authors.initials: K
authors.lastname: Ario
authors.forename: Takumi
authors.initials: T
authors.lastname: Akiyama
authors.forename: Noriko
authors.initials: N
authors.lastname: Oza
authors.forename: Taiga
authors.initials: T
authors.lastname: Otsuka
authors.forename: Takuya
authors.initials: T
authors.lastname: Kuwashiro
authors.forename: Toru
authors.initials: T
authors.lastname: Yoshimura
authors.forename: Akitaka
authors.initials: A
authors.lastname: Hisatomi
authors.forename: Iwata
authors.initials: I
authors.lastname: Ozaki
mesh_terms: 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
chemical_list: 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