Glucose Metabolism Changes in Patients with Chronic Hepatitis C Treated with Direct Acting Antivirals

Autor: Maria Szantova, Eva Mazuchova, Tomas Koller, Martin Janicko, Marian Oltman, Marek Rac, Veronika Vahalova, Lubomir Skladany, Adriana Liptakova, Miriam Ondrasova, Peter Jarcuska, Lubica Piesecka, Pavol Kristian, Ladislav Virág, Dusan Krkoska, Sylvia Drazilova, Ivan Schréter
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Blood Glucose
Liver Cirrhosis
Male
Cirrhosis
endocrine system diseases
Hepacivirus
medicine.disease_cause
Severity of Illness Index
Gastroenterology
Body Mass Index
0302 clinical medicine
Risk Factors
Fibrosis
Prevalence
Longitudinal Studies
biology
Age Factors
Fasting
General Medicine
Hepatitis C
Middle Aged
Treatment Outcome
Liver
Female
030211 gastroenterology & hepatology
Research Article
medicine.medical_specialty
Article Subject
Hepatitis C virus
030209 endocrinology & metabolism
Antiviral Agents
03 medical and health sciences
Internal medicine
Diabetes mellitus
Glucose Intolerance
medicine
Humans
lcsh:RC799-869
Retrospective Studies
Hepatology
business.industry
Type 2 Diabetes Mellitus
nutritional and metabolic diseases
Hepatitis C
Chronic
medicine.disease
Impaired fasting glucose
biology.organism_classification
Diabetes Mellitus
Type 2
lcsh:Diseases of the digestive system. Gastroenterology
business
Zdroj: Canadian Journal of Gastroenterology & Hepatology
Canadian Journal of Gastroenterology and Hepatology, Vol 2018 (2018)
ISSN: 2291-2789
DOI: 10.1155/2018/6095097
Popis: Background and Aims. Chronic hepatitis C is a systemic disease and type 2 diabetes mellitus (T2DM) belongs to more common extrahepatic. The aim of this study was to (i) explore the prevalence of impaired fasting glucose (IFG) and T2DM in patients with chronic hepatitis C, (ii) explore the effect of direct acting antivirals (DAA) treatment on the glycemia, and (iii) explore the factors that modulate the effect of DAA treatment on glycemia in patients with chronic hepatitis C.Methods. We performed a longitudinal retrospective observational study focused on the patients undergoing DAA treatment of chronic hepatitis C. Data about glycemia, history of diabetes, hepatitis C virus, treatment, and liver status, including elastography, were obtained at baseline (before treatment start), at the end of treatment and 12 weeks after the end of treatment. Patients were treated with various regimens of direct acting antivirals.Results. We included 370 patients; 45.9% had F4 fibrosis. At baseline, the prevalence of T2DM increased with the degree of fibrosis (F0-F2 14.4%, F3 21.3%, and F4 31.8%, p=0.004). Fasting glycemia also increased with the degree of fibrosis (F0-F2 5.75±0.18 F3 5.84±0.17, and F4 6.69±0.2 mmol/L, p=0.001). We saw significant decrease of glycemia after treatment in all patients, but patients without T2DM or IFG from 6.21±0.12 to 6.08±0.15 mmol/L (p=0.002). The decrease was also visible in treatment experienced patients and patients with Child-Pugh A cirrhosis.Conclusion. We confirmed that the prevalence of either T2DM or IFG increases in chronic hepatitis C patients with the degree of fibrosis. The predictive factors for T2DM were, besides F4, fibrosis also higher age and BMI. Significant decrease of fasting glycemia after the DAA treatment was observed in the whole cohort and in subgroups of patients with T2DM, IFG, cirrhotic, and treatment experienced patients.
Databáze: OpenAIRE
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