Takahashi Hirokazu, Nakahara Takashi, Kogiso Tomomi, Imajo Kento, Kessoku Takaomi, Kawaguchi Takumi, Ide Tatsuya, Kawanaka Miwa, Hyogo Hideyuki, Fujii Hideki, Ono Masafumi, Kamada Yoshihiro, Sumida Yoshio, Anzai Keizo, Shimizu Masahito, Torimura Takuji, Nakajima Atsushi, Tokushige Katsutoshi, Chayama Kazuaki, Eguchi Yuichiro
Division of Metabolism and Endocrinology, Faculty of Medicine Saga University Saga Japan.
Department of Gastroenterology and Metabolism, Graduate School of Biomedical and Health Sciences Hiroshima University Hiroshima Japan.
JGH Open. 2020 Dec 19;5(2):228-234. doi: 10.1002/jgh3.12474. eCollection 2021 Feb.
Hepatitis C virus (HCV) infection causes insulin resistance and diabetes as extrahepatic manifestations. We aimed to analyze the effect of HCV eradication by direct-acting antiviral (DAA) agents on glucose tolerance.
The hemoglobin A1c (HbA1c) of 272 patients with HCV infection who achieved a sustained virologic response (SVR) was analyzed at baseline before DAA treatment, at the end of DAA therapy (ETR), and 12 weeks after therapy (Post12W).
There were no significant differences in HbA1c between baseline, ETR, and Post12W in the overall patients. When the data were stratified according to the presence or absence of diabetes, median HbA1c significantly decreased from baseline (7.2%) to ETR (6.8%) and Post12W (6.8%) in the 55 patients with diabetes, whereas there were no significant changes in the patients without diabetes. Basal HbA1c, fasting plasma glucose, and age were independently associated with the changes in HbA1c according to multivariate analysis, and the predictive formula for changes in HbA1c was found to be ΔHbA1c (%) = 1.449-0.4* HbA1c (%) + 0.012 × Age (year). There were no changes in body mass in diabetic or nondiabetic patients. In diabetic patients taking medication, 63.4% of patients needed less medication.
Eradication of HCV improves glycemic control, indicated by a 0.4% decrease in HbA1c in diabetes.
丙型肝炎病毒（HCV）感染会引发胰岛素抵抗和糖尿病等肝外表现。我们旨在分析直接抗病毒药物（DAA）根除HCV对葡萄糖耐量的影响。
对272例获得持续病毒学应答（SVR）的HCV感染患者，在DAA治疗前的基线、DAA治疗结束时（ETR）以及治疗后12周（Post12W）分析糖化血红蛋白（HbA1c）。
总体患者中，基线、ETR和Post12W时的HbA1c无显著差异。根据糖尿病的有无对数据进行分层时，55例糖尿病患者的HbA1c中位数从基线时的7.2%显著降至ETR时的6.8%和Post12W时的6.8%，而无糖尿病的患者则无显著变化。多因素分析显示，基础HbA1c、空腹血糖和年龄与HbA1c的变化独立相关，且发现HbA1c变化的预测公式为ΔHbA1c（%）=1.449 - 0.4×HbA1c（%）+ 0.012×年龄（岁）。糖尿病或非糖尿病患者的体重均无变化。在服用药物的糖尿病患者中，63.4%的患者所需药物减少。
根除HCV可改善血糖控制，糖尿病患者的HbA1c下降0.4%即表明了这一点。
