Tanaka H, Shiota G, Kawasaki H
Second Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
J Med. 1997;28(5-6):335-46.
Interferon alpha (IFN alpha) has been widely used as therapy for chronic hepatitis C. However, changes in glucose metabolism during IFN alpha therapy in patients with chronic hepatitis C remain unknown. To study the effects of IFN alpha on glucose tolerance in patients with chronic hepatitis C, we prospectively examined glucose tolerance in 15 patients with chronic hepatitis C before and four weeks after the start of IFN alpha therapy. Serum bilirubin, albumin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) improved after the therapy compared with before (p < 0.05, respectively), while levels of fasting blood sugar, blood sugar at 30 min in 75 g-oral glucose tolerance test (OGGT) and fasting immunoreactive insulin (IRI) decreased (p < 0.05, respectively); insulinogenic index (II) also increased (p < 0.05). Response patterns in 75 g OGGT before therapy were: four patients in normal pattern, five in a borderline pattern and four in a diabetic pattern, whereas those after therapy were changed to four in a normal pattern, and eight in a borderline pattern. Changes in AST between before and after therapy were correlated with those in blood glucose at 30 min in a 75 g-OGGT (r = +0.648, p = 0.042). Although interferons have been reported to impair glucose tolerance in viral infection, the results of the present study indicate that hepatic functional recovery may be associated with improved glucose tolerance in patients with chronic hepatitis C treated with IFN alpha.
α干扰素（IFNα）已被广泛用于慢性丙型肝炎的治疗。然而，慢性丙型肝炎患者在IFNα治疗期间葡萄糖代谢的变化仍不清楚。为了研究IFNα对慢性丙型肝炎患者葡萄糖耐量的影响，我们前瞻性地检测了15例慢性丙型肝炎患者在IFNα治疗开始前及治疗四周后的葡萄糖耐量。治疗后血清胆红素、白蛋白、天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）较治疗前有所改善（p均<0.05），而空腹血糖、75g口服葡萄糖耐量试验（OGGT）中30分钟血糖及空腹免疫反应性胰岛素（IRI）水平下降（p均<0.05）；胰岛素生成指数（II）也升高（p<0.05）。治疗前75g OGGT的反应模式为：正常模式4例，临界模式5例，糖尿病模式4例，而治疗后变为正常模式4例，临界模式8例。治疗前后AST的变化与75g OGGT中30分钟血糖的变化相关（r = +0.648，p = 0.042）。虽然已有报道称干扰素会损害病毒感染患者的葡萄糖耐量，但本研究结果表明，在接受IFNα治疗的慢性丙型肝炎患者中，肝功能恢复可能与葡萄糖耐量改善有关。
