title: Heroin dependence duration influences the metabolic parameters: mechanisms and consequences of impaired insulin sensitivity in hepatitis C virus seronegative heroin dependents.
abstract: OBJECTIVE
  Carbohydrate metabolism disorder in heroin dependence is an issue with long history and contradicting results. The aim of the study was to evaluate basal insulin sensitivity in hepatitis C virus seronegative heroin dependents with normal body mass index, taking into consideration the duration of heroin dependence.
  
  
  METHODS
  78 heroin dependents and 32 healthy controls were enrolled in the cross-sectional, prospective study. The dependents were observed in 2 groups: group 1 with dependence duration less than or equal to 3 years and group 2 with more than 3 years. Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) and β-cell function (HOMA-B%) were used to define basal glucose-insulin homeostasis.
  
  
  RESULTS
  The group with longer dependence duration had HOMA-IR (2.23 ± 3.15) significantly higher compared with the control group (1.23 ± 0.53, P = 0.016) but lower compared with the group with the shorter dependence duration (2.65 ± 2.66, P = 0.024), after adjustment for HOMA-B%, waist circumference, and aspartate aminotransferase. The decrease in HOMA-IR during prolonged heroin addiction was significantly associated with the reduced β-cell function (P < 0.001) and waist circumference (P = 0.004).
  
  
  CONCLUSIONS
  Heroin dependence is associated with increased insulin resistance in hepatitis C virus seronegative heroin dependents. Prolonged heroin use is associated with reduction of basal β-cell pancreatic function with decreased insulin resistance controlled for waist circumference, but still inducing significantly decreased basal insulin sensitivity.
authors.affiliation: University Clinic of Toxicology, Skopje, Macedonia. perevska@yahoo.com
authors.forename: Zanina
authors.initials: Z
authors.lastname: Pereska
authors.forename: Cvetanka
authors.initials: C
authors.lastname: Bozinovska
authors.forename: Cedo
authors.initials: C
authors.lastname: Dimitrovski
authors.forename: Koco
authors.initials: K
authors.lastname: Cakalarovski
authors.forename: Andon
authors.initials: A
authors.lastname: Chibishev
authors.forename: Milka
authors.initials: M
authors.lastname: Zdravkovska
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Babulovska
authors.forename: Daniela
authors.initials: D
authors.lastname: Janicevic
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002047:Buprenorphine / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D006526:Hepatitis C / Q000503:physiopathology*; D003932:Heroin / Q000009:adverse effects*; D006556:Heroin Dependence / Q000503:physiopathology* / Q000534:rehabilitation; D006706:Homeostasis / Q000502:physiology; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D050417:Insulin-Secreting Cells / Q000187:drug effects / Q000502:physiology; D008297:Male; D024821:Metabolic Syndrome / Q000139:chemically induced / Q000503:physiopathology*; D008962:Models, Theoretical; D009294:Narcotics / Q000009:adverse effects*; D058850:Opiate Substitution Treatment; D011446:Prospective Studies; D018843:Republic of North Macedonia; D013223:Statistics as Topic; D055105:Waist Circumference; D055815:Young Adult
chemical_list: D009294:Narcotics; D002047:Buprenorphine; D003932:Heroin