Post-load insulin resistance does not predict virological response to treatment of chronic hepatitis C patients without the metabolic syndrome

Fattovich, Giovanna; Svegliati Baroni, Gianluca; Pasino, Michela; Pierantonelli, Irene; Covolo, Loredana; Ieluzzi, Donatella; Passigato, Nicola; Tonon, Angelo; Faraci, Maria Grazia; Guido, Maria; Negro, Francesco

doi:10.1016/j.dld.2011.12.006

« Previous Next »Digestive and Liver Disease
Volume 44, Issue 5 , Pages 419-425, May 2012

Post-load insulin resistance does not predict virological response to treatment of chronic hepatitis C patients without the metabolic syndrome

Giovanna Fattovich
- Department of Medicine, University of Verona, Verona, Italy
- Division of Gastroenterology and Endoscopy, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
- Corresponding author at: Unità Operativa Complessa di Gastroenterologia dO, Dipartimento di Medicina, Azienda Ospedaliera Universitaria Integrata Verona, Piazzale A. Stefani n. 1, 37126 Verona, Italy. Tel.: +39 045 8127257; fax: +39 045 81272014.
Gianluca Svegliati Baroni
- Department of Gastroenterology, Polytecnic University of Marche, Ancona, Italy
Michela Pasino
- Department of Medicine, University of Verona, Verona, Italy
- Division of Gastroenterology and Endoscopy, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
Irene Pierantonelli
- Department of Gastroenterology, Polytecnic University of Marche, Ancona, Italy
Loredana Covolo
- Institute of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy
Donatella Ieluzzi
- Division of Gastroenterology and Endoscopy, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
- Department of Surgery, University of Verona, Verona, Italy
Nicola Passigato
- Division of Gastroenterology and Endoscopy, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
Angelo Tonon
- Division of Gastroenterology and Endoscopy, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
Maria Grazia Faraci
- Department of Gastroenterology, Polytecnic University of Marche, Ancona, Italy
Maria Guido
- Department of Diagnostic Sciences and Special Therapies, University of Padova, Padua, Italy
Francesco Negro
- Division of Clinical Pathology, University Hospitals, Geneva, Switzerland
- Division of Gastroenterology and Hepatology, University Hospitals, Geneva, Switzerland

Received 11 July 2011; accepted 9 December 2011. published online 25 January 2012.

Abstract

Background and aim

The role of insulin resistance in predicting virological response to therapy of chronic hepatitis C is debated. We assessed the association between basal (defined as homeostasis model assessment of insulin resistance (HOMA-IR)>2) and post-load insulin resistance (as oral glucose insulin sensitivity index<9.8mg/kg/min) with the rapid and sustained virological responses in chronic hepatitis C.

Methods

Observational prospective study of 124 treatment-naïve patients with chronic hepatitis C not fulfilling the metabolic syndrome criteria, adherent to a standard treatment with pegylated interferon alpha plus ribavirin.

Results

Insulin resistance was detected in 50% (by HOMA-IR) and 29% (by oral glucose insulin sensitivity index) of patients. Independent predictors of rapid virologic response were hepatitis C virus (HCV) genotype 2 (odds ratio 5.66; 95% confidence interval 1.88–17.01), HCV genotype 3 (odds ratio 5.23; 95% confidence interval 1.84–14.84) and lower basal ferritin levels (odds ratio 0.99; 95% confidence interval 0.993–0.998). Independent predictors of sustained virologic response were HCV genotype 2 (odds ratio 19.54; 95% confidence interval 2.29–166.41) and HCV genotype 3 (odds ratio 3.24; 95% confidence interval 1.10–9.58). Rapid virologic response was by itself predictive of sustained virologic response (odds ratio 40.90; 95% confidence interval 5.37–311.53).

Conclusions

Insulin resistance, measured by both static and dynamic methods, does not predict rapid or sustained virologic response in chronic hepatitis C patients without the metabolic syndrome.

Keywords: Antiviral therapy, Chronic hepatitis, Hepatitis C virus, Homeostasis model assessment of insulin resistance (HOMA-IR), Oral glucose sensitivity (OGIS) index