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Insulin resistance is independently associated with significant hepatic fibrosis in Asian chronic hepatitis C genotype 2 or 3 patients.

Publication ,  Journal Article
Patel, K; Thompson, AJ; Chuang, W-L; Lee, C-M; Peng, C-Y; Shanmuganathan, G; Thongsawat, S; Tanwandee, T; Mahachai, V; Pramoolsinsap, C; Cho, M ...
Published in: J Gastroenterol Hepatol
July 2011

BACKGROUND AND AIM: The role of insulin resistance (IR) and hepatic steatosis in fibrogenesis in chronic hepatitis C infection (CHC) has yielded conflicting data and few studies have been performed in Asian-region populations. We retrospectively investigated the relationship between host metabolic variables, including IR and hepatic steatosis, to hepatic fibrosis in Asian-region CHC genotype 2/3 patients. METHODS: A total of 303 treatment-naïve Asian-region patients with CHC genotype 2/3 were enrolled in a multicenter phase 3 study of albinterferon alfa-2b plus ribavirin for 24 weeks. IR was defined as Homeostasis Model for Assessment of IR (HOMA-IR) > 2. Baseline liver biopsy was evaluated by a single expert histopathologist. Post hoc subgroup logistic regression modeling selected for independent variables associated with significant fibrosis (METAVIR stage F2-F4). RESULTS: Insulin resistance was available in 263 non-diabetic Asian-region patients (hepatitis C virus-2 [HCV-2] = 171, HCV-3 = 92), and 433 non-Asian region patients (407 "Caucasian"); METAVIR fibrosis prevalence F0-F1 (minimal fibrosis)= 201 (77%) and F2-F4 (significant fibrosis) = 59 (23%), and steatosis prevalence of grade 0 = 169 (65%), grade 1 = 64 (25%), grade 2/3 = 27 (10%). Median HOMA-IR was 1.8 (interquartile range: 1.2-2.7); 100 (38%) patients had HOMA-IR > 2. Factors independently associated with significant fibrosis included HOMA-IR (odds ratio [OR]= 8.42), necro-inflammatory grade (OR = 3.17), age (OR = 1.07) and serum total cholesterol levels (OR = 0.008). This was similar to non-Asian region patients, but steatosis was not associated with significant fibrosis in either cohort. CONCLUSIONS: In this subgroup study of Asian-region HCV genotype 2 or 3 patients, insulin resistance, along with age, cholesterol levels and necro-inflammation, but not steatosis may be associated with significant hepatic fibrosis.

Duke Scholars

Published In

J Gastroenterol Hepatol

DOI

EISSN

1440-1746

Publication Date

July 2011

Volume

26

Issue

7

Start / End Page

1182 / 1188

Location

Australia

Related Subject Headings

  • Severity of Illness Index
  • Retrospective Studies
  • Prognosis
  • Morbidity
  • Liver Cirrhosis
  • Interferon-alpha
  • Insulin Resistance
  • Humans
  • Hepatitis C, Chronic
  • Global Health
 

Citation

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Patel, K., Thompson, A. J., Chuang, W.-L., Lee, C.-M., Peng, C.-Y., Shanmuganathan, G., … McHutchison, J. G. (2011). Insulin resistance is independently associated with significant hepatic fibrosis in Asian chronic hepatitis C genotype 2 or 3 patients. J Gastroenterol Hepatol, 26(7), 1182–1188. https://doi.org/10.1111/j.1440-1746.2011.06722.x
Patel, Keyur, Alexander J. Thompson, Wan-Long Chuang, Chuan-Mo Lee, Chen-Yuan Peng, Ganesananthan Shanmuganathan, Satawat Thongsawat, et al. “Insulin resistance is independently associated with significant hepatic fibrosis in Asian chronic hepatitis C genotype 2 or 3 patients.J Gastroenterol Hepatol 26, no. 7 (July 2011): 1182–88. https://doi.org/10.1111/j.1440-1746.2011.06722.x.
Patel K, Thompson AJ, Chuang W-L, Lee C-M, Peng C-Y, Shanmuganathan G, et al. Insulin resistance is independently associated with significant hepatic fibrosis in Asian chronic hepatitis C genotype 2 or 3 patients. J Gastroenterol Hepatol. 2011 Jul;26(7):1182–8.
Patel, Keyur, et al. “Insulin resistance is independently associated with significant hepatic fibrosis in Asian chronic hepatitis C genotype 2 or 3 patients.J Gastroenterol Hepatol, vol. 26, no. 7, July 2011, pp. 1182–88. Pubmed, doi:10.1111/j.1440-1746.2011.06722.x.
Patel K, Thompson AJ, Chuang W-L, Lee C-M, Peng C-Y, Shanmuganathan G, Thongsawat S, Tanwandee T, Mahachai V, Pramoolsinsap C, Cho M, Han KH, Shah SR, Foster GR, Clark PJ, Pulkstenis E, Subramanian GM, McHutchison JG. Insulin resistance is independently associated with significant hepatic fibrosis in Asian chronic hepatitis C genotype 2 or 3 patients. J Gastroenterol Hepatol. 2011 Jul;26(7):1182–1188.
Journal cover image

Published In

J Gastroenterol Hepatol

DOI

EISSN

1440-1746

Publication Date

July 2011

Volume

26

Issue

7

Start / End Page

1182 / 1188

Location

Australia

Related Subject Headings

  • Severity of Illness Index
  • Retrospective Studies
  • Prognosis
  • Morbidity
  • Liver Cirrhosis
  • Interferon-alpha
  • Insulin Resistance
  • Humans
  • Hepatitis C, Chronic
  • Global Health