J Hepatol：胰岛素抵抗（IR）降低丙肝持续病毒学应答率
2012-02-04 MedSci MedSci原创
《肝脏病学杂志》[J Hepatol 2011，55（6）：1187]发表法国一项荟萃分析：与没有胰岛素抵抗（IR）的患者相比，慢性丙型肝炎伴IR的患者应用聚乙二醇干扰素加利巴韦林治疗后持续病毒学应答率低20%，基线时稳态模型评估法-IR指数是SVR的一个重要决定因素。 原始文献： Deltenre P, Louvet A, Lemoine M, Mourad A, Fartoux L, M
《肝脏病学杂志》[J Hepatol 2011，55（6）：1187]发表法国一项荟萃分析：与没有胰岛素抵抗（IR）的患者相比，慢性丙型肝炎伴IR的患者应用聚乙二醇干扰素加利巴韦林治疗后持续病毒学应答率低20%，基线时稳态模型评估法-IR指数是SVR的一个重要决定因素。
原始文献：
Deltenre P, Louvet A, Lemoine M, Mourad A, Fartoux L, Moreno C, Henrion J, Mathurin P, Serfaty L.Impact of insulin resistance on sustained response in HCV patients treated with pegylated interferon and ribavirin: a meta-analysis.J Hepatol. 2011 Dec;55(6):1187-94.
BACKGROUND
Recent studies suggested that SVR rates might be lower in HCV patients with insulin resistance (IR) than in patients without IR, but the extent of the impact of IR on treatment response has not been established. We aimed to confirm the role of IR assessed by the homoeostasis model assessment (HOMA-IR) on SVR and to determine its magnitude.
METHODS:
We performed meta-analysis of studies evaluating the impact of IR in HCV patients treated with pegylated interferon and ribavirin.
RESULTS:
Fourteen studies involving 2732 patients were included. SVR was less frequent in patients with IR than in patients without IR (mean difference: -19.6%, 95% CI: -29.9% to -9.4%, p<0.001). In sensitivity analyses according to HCV-1 patients, patients with IR also less frequently attained a SVR than patients without IR (mean difference: -13.0%, 95% CI: -22.6% to -3.4%, p=0.008). In addition, the baseline HOMA-IR index was lower in responders than in non-responders (mean difference: -0.92, 95% CI: -1.53 to -0.32, p<0.001). In sensitivity analyses restricted to HCV-1 patients, the baseline HOMA-IR index remained lower in responders than in non-responders (mean difference: -0.63, 95% CI: -1.13 to -0.14, p<0.001).
CONCLUSIONS:
HCV patients with IR have a 20% lower SVR than patients without IR. The baseline HOMA-IR index is a major determinant of SVR.
Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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- Gut: 1型慢丙肝者SVR减轻胰岛素抵抗
- PNAS：丙肝病毒通过劫持肝脏microRNA以幸存
- Nat.Med：抑制NPC1L1表达或可预防丙肝病毒感染
- 2011年AASLD基因1型丙肝治疗指南更新（附全文）
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- 大剂量聚乙二醇干扰素-α和利巴韦林在无应答的丙肝患者中的应用与IL-28B基因型的关系
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