title: Correlation between insulin resistance and outcome of pegylated interferon and ribavirin therapy, hepatic steatosis, hepatic fibrosis in chronic hepatitis C-1b and high viral load.
abstract: OBJECTIVE
  Insulin resistance (IR) has been reported to be an independent predictor of treatment outcome in chronic hepatitis C patients.
  
  
  METHODS
  We analyzed the relationship between IR and the outcome of pegylated interferon and ribavirin (PEG-IFN/RBV) therapy, taking into account host factors of body mass index and histological index, such as rate of fatty change and fibrosis. Japanese patients (n = 30; 19 men and 11 women; median age 60.0 ± 8.7 years) with chronic hepatitis C-1b with a high viral load were treated with PEG-IFN-α2b/RBV for 48 weeks.
  
  
  RESULTS
  Sustained virological response (SVR) was seen in 60% (18/30) and non-SVR in 40% (12/30). HOMA-IR (homeostasis model of assessment-insulin resistance index) at the start and at 24 weeks of treatment showed no statistical difference between SVR and non-SVR. Correlation was observed between HOMA-IR and body mass index (r = 0.45, p = 0.013). Among 20 patients, steatosis and fibrosis were assessed by biopsy. Correlation was observed between HOMA-IR and steatosis (r = 0.57, p = 0.0093), whereas no correlation was observed between HOMA-IR and fibrosis.
  
  
  CONCLUSIONS
  A larger prospective study is needed to clarify the role of IR in the outcome of PEG-IFN/RBV combination therapy and hepatic fibrosis in Japanese patients.
authors.affiliation: Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Japan. asahi-hp@arion.ocn.ne.jp
authors.forename: Soo Ryang
authors.initials: SR
authors.lastname: Kim
authors.forename: Jun
authors.initials: J
authors.lastname: Saito
authors.forename: Susumu
authors.initials: S
authors.lastname: Imoto
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Komaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Nagata
authors.forename: Taisuke
authors.initials: T
authors.lastname: Nakajima
authors.forename: Kenji
authors.initials: K
authors.lastname: Ando
authors.forename: Katsumi
authors.initials: K
authors.lastname: Fukuda
authors.forename: Yumi
authors.initials: Y
authors.lastname: Otono
authors.forename: Ke Ih
authors.initials: KI
authors.lastname: Kim
authors.forename: Aya
authors.initials: A
authors.lastname: Ohtani
authors.forename: Kayo
authors.initials: K
authors.lastname: Sugimoto
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Aya
authors.initials: A
authors.lastname: Fujinami
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Ohta
authors.forename: Hak
authors.initials: H
authors.lastname: Hotta
authors.forename: Yoko
authors.initials: Y
authors.lastname: Maekawa
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D004359:Drug Therapy, Combination; D005234:Fatty Liver / Q000503:physiopathology*; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007333:Insulin Resistance; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects*
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b