Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University Hospital Bucheon, Soonchunhyang University College of Medicine, Bucheon, Korea.
Institute for Digestive Research, Department of Internal Medicine, Soonchunhyang University Hospital Seoul, Soonchunhyang University College of Medicine, Seoul, Korea.
Clin Mol Hepatol. 2014 Mar;20(1):38-46. doi: 10.3350/cmh.2014.20.1.38. Epub 2014 Mar 26.
BACKGROUND/AIMS: Lipid profile and insulin resistance (IR) are associated with hepatitis C virus (HCV) and may predict the chronic hepatitis C (CHC) treatment response. The aim of this study was to determine the association between CHC treatment response and lipid profile and IR change during treatment.
In total, 203 CHC patients were reviewed retrospectively between January 2005 and December 2011 at Soon Chun Hyang University Hospital. The lipid profile, homeostasis model for assessment (HOMA) of IR (HOMA-IR), and HOMA of β cells (HOMA-β) were evaluated before interferon plus ribavirin therapy (BTx), at the end of treatment (DTx), and 24 weeks after the end of treatment (ATx).
A sustained virologic response (SVR) was achieved by 81% of all patients (49/60), 60% (n=36) of whom possessed genotype 1, with the remainder being non-genotype-1 (40%, n=24). Apart from age, which was significantly higher in the non-SVR group (SVR, 48.0 ± 11.2 years, mean ± SD; non-SVR, 56.6 ± 9.9 years; P<0.01), there were no significant differences in the baseline characteristics between the SVR and non-SVR groups. In the SVR group, low density lipoprotein-cholesterol (LDL-C) had significantly changed at DTx and ATx compared to BTx. In addition, HOMA-IR and HOMA-β were significantly changed at DTx in the SVR group. Among those with a high baseline insulin resistance (HOMA-IR >2.5), HOMA-IR was significantly changed at DTx in the SVR group.
LDL-C appears to be associated with HCV treatment in SVR patients. Furthermore, eradication of HCV may improve whole-body IR and insulin hypersecretion, as well as high baseline insulin resistance (HOMA-IR >2.5).
背景/目的：血脂谱和胰岛素抵抗（IR）与丙型肝炎病毒（HCV）相关，并可能预测慢性丙型肝炎（CHC）的治疗反应。本研究的目的是确定 CHC 治疗反应与治疗期间血脂谱和 IR 变化之间的关系。
回顾性分析 2005 年 1 月至 2011 年 12 月在韩国顺天乡大学医院就诊的 203 例 CHC 患者。在干扰素联合利巴韦林治疗（BTx）前、治疗结束时（DTx）和治疗结束后 24 周（ATx）评估血脂谱、胰岛素抵抗评估的稳态模型（HOMA）-IR（HOMA-IR）和 HOMA-β。
所有患者中有 81%（49/60）获得持续病毒学应答（SVR），其中 60%（n=36）为基因型 1，其余为非基因型 1（40%，n=24）。除非 SVR 组年龄显著较高（SVR，48.0±11.2 岁；非 SVR，56.6±9.9 岁；P<0.01）外，SVR 组和非 SVR 组之间的基线特征无显著差异。在 SVR 组中，与 BTx 相比，DTx 和 ATx 时低密度脂蛋白胆固醇（LDL-C）明显变化。此外，SVR 组在 DTx 时 HOMA-IR 和 HOMA-β明显变化。在基线胰岛素抵抗较高（HOMA-IR>2.5）的患者中，SVR 组在 DTx 时 HOMA-IR 明显变化。
LDL-C 似乎与 SVR 患者的 HCV 治疗相关。此外，HCV 的清除可能改善全身 IR 和胰岛素分泌过多，以及高基线胰岛素抵抗（HOMA-IR>2.5）。
