The outcomes of glucose abnormalities in pre-diabetic chronic hepatitis C patients receiving peginterferon plus ribavirin therapy.

Abstract

BACKGROUND/AIMS:

Pre-diabetes is a risk factor for type 2 diabetes mellitus (DM) development. This study aimed to elucidate the impact of treatment response on sequential changes in glucose abnormalities in pre-diabetic chronic hepatitis C (CHC) patients.

METHODS:

Chronic Hepatitis C patients with a baseline haemoglobin A1C (A1C) range 5.7-6.4% who achieved 80/80/80 adherence were prospectively recruited. All patients received current peginterferon-based recommendations. The primary outcome measurement was their A1C level at the end of follow-up (EOF). The interaction between variants of the IL28B gene and outcomes of glucose metabolism was also measured.

RESULTS:

A total of 181 consecutive CHC patients were enrolled. The mean A1C at EOF was 5.82 ± 0.41%, which was significantly lower than the baseline level (5.93 ± 0.21%, P < 0.001). At EOF, 63 (34.8%) patients became normoglycaemic, whereas 10 (5.5%) patients developed DM. The sustained virological response (SVR) rates of 63 normoglycaemics, 108 pre-diabetics and 10 diabetic patients at the EOF were 92.1%, 84.3% and 50% respectively (normoglycaemics vs. diabetics P = 0.003; pre-diabetics vs. diabetics P = 0.02). Achievement of an SVR was the only predictive factor associated with normoglycaemia development at EOF by multivariate logistic regression analysis (Odds ratio = 2.6, P = 0.04). The prevalence of the interleukin 28B rs8099917 TT variant in patients who developed DM (70.0%) at EOF tended to be lower than that in patients with pre-diabetics (87.0%) or normoglycaemics (92.1%).

CONCLUSION:

Successful eradication of HCV improves glucose abnormalities in pre-diabetic CHC patients.

• Authors: Jee-Fu Huang, Ming-Lung Yu, Chung-Feng Huang, Suh-Hang Hank Juo, Chia-Yen Dai, Ming-Yen Hsieh, Nei-Jen Hou, Ming-Lun Yeh, Meng-Hsuan Hsieh, Jeng-Fu Yang, Zu-Yau Lin, Shinn-Chern Chen, Shyi-Jang Shin, Wan-Long Chuang
• Journal: Liver international : official journal of the International Association for the Study of the Liver (Liver Int) Vol. 32 Issue 6 Pg. 962-9 (Jul 2012) ISSN: 1478-3231 [Electronic] United States
• PMID: 22356575 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: © 2012 John Wiley & Sons A/S.

Chemical References

• Antiviral Agents
• Biomarkers
• Blood Glucose
• Glycated Hemoglobin A
• interferon-lambda, human
• Interferon alpha-2
• Interferon-alpha
• Interleukins
• Recombinant Proteins
• hemoglobin A1c protein, human
• Polyethylene Glycols
• Ribavirin
• Interferons
• peginterferon alfa-2b
• peginterferon alfa-2a

Topics

• Adult
• Aged
• Antiviral Agents (therapeutic use)
• Biomarkers (blood)
• Blood Glucose (metabolism)
• Chi-Square Distribution
• Drug Therapy, Combination
• Female
• Glycated Hemoglobin (metabolism)
• Hepatitis C, Chronic (blood, complications, diagnosis, drug therapy, genetics)
• Humans
• Interferon alpha-2
• Interferon-alpha (therapeutic use)
• Interferons
• Interleukins (genetics)
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Odds Ratio
• Polyethylene Glycols (therapeutic use)
• Polymorphism, Single Nucleotide
• Prediabetic State (blood, complications, genetics)
• Prospective Studies
• Recombinant Proteins (therapeutic use)
• Ribavirin (therapeutic use)
• Risk Assessment
• Risk Factors
• Taiwan
• Treatment Outcome
• Viral Load