Tai T-Y, Lu J-Y, Chen C-L, Lai M-Y, Chen P-J, Kao J-H, Lee C-Z, Lee H-S, Chuang L-M, Jeng Y-M
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
J Endocrinol. 2003 Sep;178(3):457-65. doi: 10.1677/joe.0.1780457.
This study aimed at elucidating the effects of interferon (IFN)-alpha on glucose metabolism in patients with chronic hepatitis B and C infections. Twenty-eight biopsy-proven patients with chronic hepatitis B (ten cases) and hepatitis C (18 cases) were given IFN-alpha for a total of 24 weeks. The patients received a 75 g oral glucose tolerance test (OGTT), glucagon stimulation test, tests for type 1 diabetes-related autoantibodies and an insulin suppression test before and after IFN-alpha therapy. Ten of the 28 patients responded to IFN-alpha therapy. Steady-state plasma glucose of the insulin suppression test decreased significantly in responders (13.32+/-1.48 (S.E.M.) vs 11.33+/-1.19 mmol/l, P=0.0501) but not in non-responders (12.29+/-1.24 vs 11.11+/-0.99 mmol/l, P=0.2110) immediately after completion of IFN-alpha treatment. In the oral glucose tolerance test, no significant difference was observed in plasma glucose in either responders (10.17+/-0.23 vs 10.03+/-0.22 mmol/l) or non-responders (10.11+/-0.22 vs 9.97+/-0.21 mmol/l) 3 Months after completion of IFN-alpha treatment. However, significant differences were noted in C-peptide in both responders (2.90+/-0.13 vs 2.20+/-0.09 nmol/l, P=0.0040) and non-responders (2.45+/-0.11 vs 2.22+/-0.08 nmol/l, P=0.0287) before vs after treatment. The changes of C-peptide in an OGTT between responders and non-responders were also significantly different (P=0.0028), with responders reporting a greater reduction in C-peptide. No case developed autoantibodies during the treatment. In patients who were successfully treated with IFN-alpha, insulin sensitivity improved and their plasma glucose stayed at the same level without secreting as much insulin from islet beta-cells.
本研究旨在阐明α干扰素（IFN）对慢性乙型和丙型肝炎感染患者糖代谢的影响。28例经活检证实的慢性乙型肝炎患者（10例）和丙型肝炎患者（18例）接受了共24周的α干扰素治疗。患者在α干扰素治疗前后接受了75g口服葡萄糖耐量试验（OGTT）、胰高血糖素刺激试验、1型糖尿病相关自身抗体检测和胰岛素抑制试验。28例患者中有10例对α干扰素治疗有反应。在完成α干扰素治疗后，胰岛素抑制试验中的稳态血糖在有反应者中显著下降（13.32±1.48（标准误）对11.33±1.19mmol/L，P=0.0501），而在无反应者中未下降（12.29±1.24对11.11±0.99mmol/L，P=0.2110）。在口服葡萄糖耐量试验中，在完成α干扰素治疗3个月后，有反应者（10.17±0.23对10.03±0.22mmol/L）和无反应者（10.11±0.22对9.97±0.21mmol/L）的血糖均未观察到显著差异。然而，治疗前后有反应者（2.90±0.13对2.20±0.09nmol/L，P=0.0040）和无反应者（2.45±0.11对2.22±0.08nmol/L，P=0.0287）的C肽均有显著差异。有反应者和无反应者在OGTT中C肽的变化也有显著差异（P=0.0028），有反应者的C肽下降幅度更大。治疗期间无病例出现自身抗体。在成功接受α干扰素治疗的患者中，胰岛素敏感性提高，血糖保持在同一水平，胰岛β细胞分泌的胰岛素减少。
