title: The evolving relationship between adiponectin and insulin sensitivity in hepatitis C patients during viral clearance.
abstract: The evolution of the relationship between adiponectin and insulin sensitivity in hepatitis C virus (HCV) patients during viral clearance is unclear and warrants investigation.
  
  
  
  A prospective study including 747 consecutive chronic hepatitis C (CHC) patients, of whom 546 had completed a course of anti-HCV therapy and underwent pre-, peri- and post-therapy surveys for anthropomorphic, viral, metabolic and hepatic profiles and adiponectin levels, was conducted in a tertiary care center.
  
  
  
  Multivariate analyses indicated associations of sex, triglyceride levels and hepatic steatosis with adiponectin levels and of triglyceride levels and interferon λ3 (IFNL3) genotype with homeostasis model assessment-estimated insulin resistance (HOMA-IR) levels before anti-HCV therapy. In patients with a sustained virological response (SVR; n = 455), at 24 weeks post-therapy, sex, BMI, aspartate aminotransferase to platelet ratio index (APRI), HOMA-IR and steatosis were associated with adiponectin levels, and IFNL3 genotype was associated with HOMA-IR levels. GEE analysis demonstrated that SVR affected longitudinal trends in adiponectin levels. Compared with pre-therapy levels, adiponectin and APRI levels decreased 24 weeks post-therapy in SVR patients, regardless of baseline insulin resistance (IR). However, HOMA-IR levels decreased in SVR patients with baseline IR but increased in those without baseline IR. Compared with controls, immunohistochemical studies showed that pre-therapy CHC patients had higher hepatic adiponectin expression associated with hepatic fibrosis.
  
  
  
  During HCV infection, adiponectin may affect insulin sensitivity through triglycerides. After viral clearance, adiponectin levels were directly associated with insulin sensitivity and decreased upon improved hepatic fibrosis; with a link to the IFNL3 genotype, insulin sensitivity improved only in patients with baseline IR.
authors.affiliation: a Liver Research Center, Division of Hepatology, Department of Gastroenterology and Hepatology , Chang Gung Memorial Hospital , Taoyuan, Taiwan.|b Department of Medicine , College of Medicine, Chang Gung University , Taoyuan, Taiwan.
authors.forename: Ming-Ling
authors.initials: ML
authors.lastname: Chang
authors.affiliation: a Liver Research Center, Division of Hepatology, Department of Gastroenterology and Hepatology , Chang Gung Memorial Hospital , Taoyuan, Taiwan.
authors.forename: Chia-Jung
authors.initials: CJ
authors.lastname: Kuo
authors.affiliation: c Graduate Institute of Health-Industry Technology, Chang Gung University of Science and Technology , Taoyuan, Taiwan.|d Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology , Taoyuan, Taiwan.
authors.forename: Li-Heng
authors.initials: LH
authors.lastname: Pao
authors.affiliation: a Liver Research Center, Division of Hepatology, Department of Gastroenterology and Hepatology , Chang Gung Memorial Hospital , Taoyuan, Taiwan.
authors.forename: Chen-Ming
authors.initials: CM
authors.lastname: Hsu
authors.affiliation: a Liver Research Center, Division of Hepatology, Department of Gastroenterology and Hepatology , Chang Gung Memorial Hospital , Taoyuan, Taiwan.
authors.forename: Cheng-Tang
authors.initials: CT
authors.lastname: Chiu
mesh_terms: D052242:Adiponectin / Q000235:genetics / Q000378:metabolism*; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics / Q000502:physiology*; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000235:genetics / Q000378:metabolism* / Q000821:virology; D006801:Humans; D007328:Insulin / Q000378:metabolism*; D007333:Insulin Resistance; D007372:Interferons; D007378:Interleukins / Q000235:genetics / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019562:Viral Load / Q000187:drug effects; D000095022:Interferon Lambda
chemical_list: D052242:Adiponectin; D000998:Antiviral Agents; D007328:Insulin; D007372:Interferons; D007378:Interleukins; C000624353:interferon-lambda, human; D000095022:Interferon Lambda
keywords: HCV; HOMA-IR; adiponectin; insulin sensitivity; triglycerides