Michalczuk Matheus Truccolo, Kappel Camila Rippol, Birkhan Oscar, Bragança Ana Carolina, Alvares-da-Silva Mário Reis
Gastroenterology Division, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos 2350, 90035-003 Porto Alegre, RS, Brazil.
Int J Hepatol. 2012;2012:576584. doi: 10.1155/2012/576584. Epub 2012 Jul 16.
Introduction. There is an association between HCV and insulin resistance (IR), which is currently assessed by HOMA-IR. There is evidence that HOMA-adiponectin (HOMA-AD) is more accurate, but its role in HCV patients is unknown. The purpose of this study was to evaluate IR in an HCV sample and controls, in order to compare the accuracy of HOMA-IR and HOMA-AD. Methods. Ninety-four HCV outpatients aged <60 years who met the criteria of nondiabetic, nonobese, noncirrhotic, and nonalcohol abusers were included and compared to 29 controls. Fasting glucose, insulin, adiponectin, and lipid profiles were determined. IR was estimated by HOMA-IR and HOMA-AD. Results. The groups were similar regarding sex and BMI, but the HCV patients were older. The median insulin level was higher in the HCV group (8.6 mU/mL (6.5-13.7) versus 6.5 (4.3-10.7), P = 0.004), as was median HOMA-IR (1.94 (1.51 to 3.48) versus 1.40 (1.02 to 2.36), P = 0.002) and the prevalence of IR (38.3% versus 10.3% (P = 0.009)). No differences were found in adiponectin levels (P = 0.294) and HOMA-AD (P = 0.393). Conclusion. IR is highly prevalent even in low-risk HCV outpatients. Adiponectin is not influenced by the presence of HCV. HOMA-AD does not seem to be useful in assessing IR in HCV patients.
引言。丙型肝炎病毒（HCV）与胰岛素抵抗（IR）之间存在关联，目前通过稳态模型评估胰岛素抵抗（HOMA-IR）来进行评估。有证据表明，稳态模型评估脂联素（HOMA-AD）更为准确，但其在HCV患者中的作用尚不清楚。本研究的目的是评估HCV样本及对照中的IR，以比较HOMA-IR和HOMA-AD的准确性。方法。纳入94名年龄小于60岁、符合非糖尿病、非肥胖、非肝硬化且非酗酒者标准的HCV门诊患者，并与29名对照进行比较。测定空腹血糖、胰岛素、脂联素和血脂谱。通过HOMA-IR和HOMA-AD评估IR。结果。两组在性别和体重指数方面相似，但HCV患者年龄更大。HCV组的胰岛素中位数水平更高（8.6 mU/mL（6.5 - 13.7）对6.5（4.3 - 10.7），P = 0.004），稳态模型评估胰岛素抵抗（HOMA-IR）中位数也是如此（1.94（1.51至3.48）对1.40（1.02至2.36），P = 0.002）以及IR患病率（38.3%对10.3%（P = 0.009））。脂联素水平（P = 0.294）和稳态模型评估脂联素（HOMA-AD）方面未发现差异（P = 0.393）。结论。即使在低风险的HCV门诊患者中，IR也非常普遍。脂联素不受HCV存在的影响。稳态模型评估脂联素（HOMA-AD）似乎对评估HCV患者的IR无用。
