Dr Raymond D'Souza and colleagues from England assessed whether insulin resistance is associated with liver fibrosis in patients with chronic Hepatitis C.
The researchers also assessed whether there were any differences in insulin resistance between Asians and the indigenous Caucasian population.
The research team ascertained whether insulin resistance is associated with sustained virological response to antiviral therapy.
| 56% completing a course of antiviral treatment had a sustained virological response|
|American Journal of Gastroenterology|
The team determined insulin resistance in 59 patients with Hepatitis C, of which 30 were Caucasian and 29 were Asian, prior to starting antiviral therapy.
The researchers measured insulin resistance using the homeostasis model assessment of insulin resistance (HOMA-IR).
The relationship between insulin resistance and biochemical, virological, and histological data together with response to antiviral therapy was determined.
The team found, using multivariable analyses, that insulin resistance correlated positively with the stage of fibrosis.
Higher degrees of insulin resistance were found in those with greater degrees of fibrosis.
The team noted that this relationship remained after excluding cirrhotic patients, or after adjusting for other factors associated with fibrosis in univariable analyses.
The researchers observed that insulin resistance was significantly higher in Asians than Caucasians.
The team noted that 56% of patients completing a course of antiviral treatment had a sustained virological response.
Multivariable logistic regression identified Hepatitis C virus genotype 3 as being associated with a higher odds of a sustained virological response.
In addition, the team identified lower fasting glucose levels, and lower aspartate transaminase levels to be associated with a higher sustained virological response.
After adjusting for these variables, Asian ethnicity, and higher fasting insulin levels were associated with a poorer virological response to therapy.
The team noted that poorer virological response to therapy was also associated higher levels of homeostasis model assessment of insulin resistance.
Dr D'Souza's team concludes, “Insulin resistance contributes to liver fibrosis in chronic Hepatitis C infection, and this relationship is not genotypic specific.”
“Asian patients had higher insulin resistance than Caucasians.”
“Insulin resistance is also an important predictor of sustained response to antiviral therapy.”