Cheng Pin-Nan, Sun Hung-Yu, Feng I-Che, Chiu Yen-Cheng, Wang Sin-Tian, Tan Dyoness Charmaine, Chiu Hung-Chih, Chien Shih-Chih, Young Kung-Chia
Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Biomedical Engineering, College of Biology, Hunan University, Changsha, China; Institute of Pathogen Biology and Immunology of College of Biology, Hunan Provincial Key Laboratory of Medical Virology, Hunan University, Changsha, China; Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
J Microbiol Immunol Infect. 2023 Feb;56(1):20-30. doi: 10.1016/j.jmii.2022.06.004. Epub 2022 Jul 6.
Chronic hepatitis C virus (HCV) infection causes various liver diseases and metabolic disorders. With direct-acting antiviral agents (DAAs), which effectively eradicate pan-genotypic HCV, hepatic and concomitant metabolic restorations are achieved. The study aims to evaluate the posttherapeutic benefits of lipid and glycemic homeostasis.
Nighty-five chronic hepatitis C patients who achieved sustained virological response (SVR) by using DAAs were enrolled to collect plasma samples and fractionated lipoproteins at baseline, SVR, and during the post-SVR follow-ups for 6 months (pS6m) and 1 year (pS1yr). The lipid and glycemic parameters were analyzed to establish muturally modulatory relationships.
Plasma cholesterol (Chol) and glucose were elevated at SVR from baseline, whereas plasma Chol remained increased until pS1yr; however, glucose returned to the basal level. The post-SVR responses included a peak elevation of glycated hemoglobin at pS6m, a sustained elevation of triglyceride (Tg), and sustained declines in insulin, homeostasis model assessment (HOMA)-insulin resistance, and HOMA-beta levels until pS1yr. The changes in plasma Chol and high-density-lipoprotein Chol showed positive correlations, as did the plasma Tg with low-density-lipoprotein Tg and very-low-density-lipoprotein Tg per particle load. Very-low-density-lipoprotein was found to be loaded with increased Tg and Chol and underwent efficient Tg catabolism in the form of conversion into low-density-lipoprotein. Additionally, the posttherapeutic dynamics exhibited correlations of high-density-lipoprotein Chol with plasma glucose and HOMA-beta.
Irrespective of the baseline metabolic status, the posttherapeutic interdependent modulation of blood glycemic and lipid metabolic parameters were revealed in chronic hepatitis C patients following clearance of HCV viremia by DAA treatment.
慢性丙型肝炎病毒（HCV）感染会引发各种肝脏疾病和代谢紊乱。使用直接作用抗病毒药物（DAA）可有效根除泛基因型HCV，实现肝脏及伴随的代谢恢复。本研究旨在评估脂质和血糖稳态的治疗后益处。
纳入95例通过使用DAA实现持续病毒学应答（SVR）的慢性丙型肝炎患者，在基线、SVR时以及SVR后6个月（pS6m）和1年（pS1yr）的随访期间采集血浆样本并分离脂蛋白。分析脂质和血糖参数以建立相互调节关系。
与基线相比，SVR时血浆胆固醇（Chol）和葡萄糖升高，而血浆Chol在pS1yr之前一直保持升高；然而，葡萄糖恢复到基础水平。SVR后的反应包括pS6m时糖化血红蛋白的峰值升高、甘油三酯（Tg）的持续升高，以及胰岛素、稳态模型评估（HOMA）-胰岛素抵抗和HOMA-β水平在pS1yr之前持续下降。血浆Chol和高密度脂蛋白胆固醇的变化呈正相关，血浆Tg与每颗粒负荷的低密度脂蛋白Tg和极低密度脂蛋白Tg也呈正相关。发现极低密度脂蛋白负载的Tg和Chol增加，并以转化为低密度脂蛋白的形式进行有效的Tg分解代谢。此外，治疗后的动态变化显示高密度脂蛋白胆固醇与血浆葡萄糖和HOMA-β之间存在相关性。
无论基线代谢状态如何，在慢性丙型肝炎患者经DAA治疗清除HCV病毒血症后，揭示了血糖和脂质代谢参数在治疗后的相互依赖调节。
