Peripheral insulin resistance during treatment of chronic hepatitis C with peguilated interferon plus ribavirin.

Vivianne Mello, Thomaz Cruz, Geila Nuñez, Maria Tereza Simões, Fabrizio Ney-Oliveira, Hélio Braga, César Araújo, Simone Cunha, Maria Isabel Schinoni, Marla Cruz, Raymundo Parana

Journal: Journal of medical virology 2006;78(11):1406-10

PMID: 16998879

Abstract

UNLABELLED

Patients with hepatitis C virus (HCV) infection present higher risk of developing type-2 diabetes mellitus (DM). However, the mechanism of this association and the role of antiviral treatment are still unclear. The objective of this study was to investigate the relationship between the use of peguilated interferon and the development of insulin resistance (IR) in these patients.

METHODS

HOMA index was evaluated in 30 HCV-infected patients just before and during the first 6 months of treatment with peguilated interferon plus ribavirin. Anthropometrical parameters and glucose/cholesterol profile were also monitored.

RESULTS

No changes in HOMA after 6 months of treatment were observed. Glucose levels decreased but not significantly (P = 0.059). Patients with higher HOMA index after 6 months of treatment also presented higher aminotransferase levels (P = 0.03), higher fat index on computed tomography (P = 0.011), longer time of exposure to the virus (P = 0.021), and a positive smoking history when compared to non-insulin resistant patients (P = 0.045). There was no influence of fibrosis stage on liver biopsy in the insulin-resistance development.

CONCLUSIONS

No changes in the IR were observed after 6 months of treatment. Insulin resistance is related to the abdominal fat and anthropometrical parameters rather than to the antiviral treatment.

Address: Post-Graduation Course in Medicine and Health, Federal University of Bahia, Bahia, Brazil. [email protected]

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