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

Patel, Keyur, Thompson, Alexander J., Chuang, Wan-Long, Lee, Chuan-Mo, Peng, Chen-Yuan, Shanmuganathan, Ganesananthan, Thongsawat, Satawat, Tanwandee, Tawesak, Mahachai, Varocha, Pramoolsinsap, Chutima, Cho, Mong, Han, Kwang Hyup, Shah, Samir R., Foster, Graham R., Clark, Paul J., Pulkstenis, Erik, Subramanian, G. Mani and McHutchison, John G. (2011) Insulin resistance is independently associated with significant hepatic fibrosis in Asian chronic hepatitis C genotype 2 or 3 patients. Journal of Gastroenterology and Hepatology (Australia), 26 7: 1182-1188. doi:10.1111/j.1440-1746.2011.06722.x


Author Patel, Keyur
Thompson, Alexander J.
Chuang, Wan-Long
Lee, Chuan-Mo
Peng, Chen-Yuan
Shanmuganathan, Ganesananthan
Thongsawat, Satawat
Tanwandee, Tawesak
Mahachai, Varocha
Pramoolsinsap, Chutima
Cho, Mong
Han, Kwang Hyup
Shah, Samir R.
Foster, Graham R.
Clark, Paul J.
Pulkstenis, Erik
Subramanian, G. Mani
McHutchison, John G.
Title Insulin resistance is independently associated with significant hepatic fibrosis in Asian chronic hepatitis C genotype 2 or 3 patients
Journal name Journal of Gastroenterology and Hepatology (Australia)   Check publisher's open access policy
ISSN 0815-9319
1440-1746
Publication date 2011-07
Sub-type Article (original research)
DOI 10.1111/j.1440-1746.2011.06722.x
Open Access Status
Volume 26
Issue 7
Start page 1182
End page 1188
Total pages 7
Place of publication Richmond Australia
Publisher Wiley-Blackwell Publishing Asia
Language eng
Subject 2715 Gastroenterology
2721 Hepatology
Formatted abstract
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 24weeks. 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.
Keyword Caucasian
Ethnic
Hepatitis C virus infection
Liver
Metabolic
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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Created: Tue, 16 Sep 2014, 12:54:28 EST by Ms Kate Rowe on behalf of School of Medicine