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Interesting Study on Insulin Resistance

J Hepatol. 2009 Apr;50(4):712-718.

Insulin resistance predicts response to peginterferon-alpha/ribavirin combination therapy in chronic hepatitis C patients.

Dai CY, Huang JF, Hsieh MY, Hou NJ, Lin ZY, Chen SC, Hsieh MY, Wang LY, Chang WY, Chuang WL, Yu ML.
Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd, Kaohsiung 807, Taiwan; Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Occupational and Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

BACKGROUND/AIMS: Insulin resistance (IR) might be associated with hepatitis C virus (HCV) infection. This study aimed to elucidate impact of IR and beta-cell function on the response to peginterferon-alpha (PEG-IFN)/ribavirin combination therapy in chronic hepatitis C (CHC) patients.

METHODS: Three hundred and thirty patients without overt diabetes were treated with combination therapy with (PEG-IFN)/ribavirin for 24 weeks. The IR and beta-cell function were evaluated by homeostasis model assessment of IR (HOMA-IR) and homeostasis model assessment of beta-cell function (HOMA-beta) before treatment.

RESULTS: HCV genotype, pretreatment HCV RNA level and pretreatment HOMA-IR, but not HOMA-beta, were independent factors associated with sustained virologic response (SVR). In 150 patients with genotype 1b infection, pretreatment HCV RNA level, HOMA-IR and age were independent predictors for SVR. The significantly lower SVR rate in high HOMA-IR patients was observed in 76 patients with high HCV RNA levels (400,000IU/mL) who were defined as 'difficult-to-treat' patients. The mean HOMA-IR of 'difficult-to-treat' patients was significantly lower in 42 sustained responders than in 34 non-responders.

CONCLUSIONS: IR was associated with SVR to (PEG-IFN)/ribavirin therapy for CHC, especially among 'difficult-to-treat' patients. These findings suggested clinical application of pretreatment HOMA-IR could enable treatment outcome to be predicted and treatment regimens to be determined.
85 Responses
Avatar universal
Treatment may not be in vain for those who may not know that they are IR or boarder line diabetic and to be tested before starting treatment will give more information for a better outcome rather than finding out that the past 48 weeks was a waste.
jasper
Avatar universal
Thank you Max
Avatar universal
Just a matter to time wasn't it.......
Avatar universal
Correction:  matter OF time
479244 tn?1271567259

Wish I had read something about IR before I treated and failed.

Still fighting it.. just got my labs today.
HOMA = 4.48  ... uggghh.

Jacked up the metormin , hopefully that will help.
Took me a long time to become IR and it will probably take awhile to get back to "normal".

My dad was a type II diabetic, so was his mother.
If you have a family history of diabetes , it is worth looking in to.

IR's are 7 years from progressing to type II diabetes if not treated.
Wish they had known about IR (many doctors are still not aware, mine wasn't) when my dad was alive.  He eventually progressed to renal disease and diaylisis (sp?).
they always said the kidney problem caused the diabetes... but I am convinced that the diabetes caused his kidney problems.



bandman
Avatar universal
It would have been fine if the case in point was just IR awareness but we know it goes a whole lot deeper than that.  
Let sleeping dogs lie
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