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Hepatitis C virus eradication by direct antiviral agents improves glucose tolerance and reduces post‐load insulin resistance in nondiabetic patients with genotype 1
Author(s) -
Salomone Federico,
Catania Maurizio,
Montineri Arturo,
Bertino Gaetano,
Godos Justyna,
Rizzo Leonardo,
Magrì Giovanni,
Li Volti Giovanni
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13669
Subject(s) - medicine , insulin resistance , cirrhosis , impaired glucose tolerance , hepatitis c virus , gastroenterology , glucose tolerance test , viral load , insulin , liver disease , population , hepatitis c , endocrinology , immunology , virus , environmental health
Background and Aims Genotype 1 chronic hepatitis C is associated with an impairment of glucose homoeostasis, especially in the advanced stages of the disease. Glucose tolerance is an independent predictor of liver‐related mortality in patients with cirrhosis because of chronic hepatitis C. However, no study has demonstrated so far weather hepatitis C virus clearance affects glucose tolerance. Methods To this aim, we performed a prospective study assessing the effects of direct antiviral agents treatment in nondiabetic cirrhotic patients with genotypes 1a/1b and impaired glucose tolerance based on a 75‐g oral glucose tolerance test. Impaired glucose tolerance was diagnosed by a 2‐hour plasma glucose between 140 and 199 mg/dL. Insulin resistance was estimated by the oral glucose insulin sensitivity index, an oral glucose tolerance test‐derived measure. Results After meeting the inclusion criteria, the study population included 32 outpatients (26/6 genotypes 1b/1a; age 62 ± 7.4 years; 18 males) with compensated Child‐A cirrhosis. All patients achieved a sustained virological response following direct antiviral agents treatment. After viral eradication, we did not observe change in fasting plasma glucose (103.5 ± 7.1 vs 102.8 ± 7.2 mg/dL, P = .15) but 2‐hour plasma glucose was reduced (165.2 ± 22.7 vs 138.5 ± 21.3 mg/dL, P < .001). Hepatitis C virus eradication led also to a significant reduction in HbA1c (6.1 ± 0.2% vs 5.7 ± 0.3%, P < .001) and post‐load insulin resistance as assessed by the oral glucose insulin sensitivity index (6.92 ± 1.56 vs 9.52 ± 1.39 mg/kg/min, P < .001). These effects were observed despite no change in body mass index from baseline to follow‐up (25.6 ± 4.3 vs 25.8 ± 4.4, P > .5). Conclusions Our results indicate that hepatitis C virus eradication may early improve glucose tolerance in patients with hepatitis C virus‐related cirrhosis.