The homeostasis model assessment of the insulin resistance score is not predictive of a sustained virological response in chronic hepatitis C patients

被引：32

作者：

Fattovich, Giovanna ^{[1
,2
]}

Covolo, Loredana ^{[3
]}

Pasino, Michela ^{[1
]}

Perini, Eleonora ^{[3
]}

Rossi, Luigi ^{[4
]}

Brocco, Giorgio ^{[4
]}

Guido, Maria ^{[5
]}

Cristofori, Chiara ^{[1
]}

Belotti, Caterina ^{[3
]}

Puoti, Massimo ^{[6
]}

Gaeta, Giovanni Battista ^{[7
]}

Santantonio, Teresa ^{[8
]}

Raimondo, Giovanni ^{[9
]}

Bruno, Raffaele ^{[10
]}

Minola, Eliseo ^{[11
]}

Negro, Francesco ^{[2
,12
,13
]}

Donato, Francesco ^{[3
]}

机构：

[1] Univ Verona, Dipartimento Med, Gastroenterol Clin, I-37134 Verona, Italy

[2] Univ Hosp, Dept Clin Pathol, Geneva, Switzerland

[3] Univ Brescia, Inst Hyg Epidemiol & Publ Hlth, Brescia, Italy

[4] Univ Verona, Lab Biochem Haematol & Mol Biol, I-37134 Verona, Italy

[5] Univ Padua, Dept Diagnost Sci & Special Therapies, Padua, Italy

[6] Univ Brescia, Inst Infect & Trop Dis, Brescia, Italy

[7] Univ Naples Federico II, Viral Hepatitis Unit, Naples, Italy

[8] Univ Foggia, Clin Infect Dis, Foggia, Italy

[9] Univ Messina, Dept Internal Med, Messina, Italy

[10] Univ Pavia, Inst Infect & Trop Dis, I-27100 Pavia, Italy

[11] Osped Riuniti Bergamo, Clin Infect Dis, Bergamo, Italy

[12] Univ Hosp, Div Gastroenterol, Geneva, Switzerland

[13] Univ Hosp, Div Hepatol, Geneva, Switzerland

来源：

LIVER INTERNATIONAL | 2011年 / 31卷 / 01期

关键词：

hepatitis C virus genotype; homeostasis model assessment of insulin resistance; metabolic syndrome; rapid virological response; sustained virological response; treatment-naive patients; VIRUS-INFECTION; NONDIABETIC PATIENTS; COMBINATION THERAPY; GENOTYPE-1; PATIENTS; INTERFERON-ALPHA; PEGINTERFERON; PIOGLITAZONE; RIBAVIRIN; FIBROSIS; IMPACT;

D O I：

10.1111/j.1478-3231.2010.02343.x

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Objectives: To investigate the independent association between the homeo-stasis model assessment of the insulin resistance (HOMA-IR) score and rapid virological response (RVR) and sustained virological response (SVR) in chronic hepatitis C (CHC). Methods: Observational prospective cohort study of 412 CHC patients [59% males; mean age 45 years; genotype 1 (44%), 2 (32%), 3 (19%) and 4 (5%)] treated with pegylated interferon a plus ribavirin. Results: A HOMA-IR >= 2.0 was present in 49% and a metabolic syndrome in 4% of patients. By multivariate analysis, independent predictors of SVR were the lack of advanced fibrosis (>= F3) in genotype 1 and a lower body mass index in genotype 3 patients. In the subgroup of patients in whom HCV-RNA was evaluated at week 4 (n = 281), independent predictors of RVR were HCV-RNA <700 000 IU/ml, age <40 years and lower aspartate aminotransferase: alanine aminotransferase ratio in genotype 1 and baseline HOMA-IR <= 2 in genotype 3 patients. No predictive factor of RVR was identified among genotype 2 patients. RVR was the strongest predictor of SVR among genotype 1 or 3 patients. Conclusions: In this series of treatment-naive, Caucasian CHC patients at a low risk for the metabolic syndrome, HOMA-IR is not a predictor of SVR, irrespective of the HCV genotype, although it may predict RVR in genotype 3 infection.

引用

页码：66 / 74

页数：9