Severity of liver disease predicts the development of glucose abnormalities in patients with chronic hepatitis B or C following achievement of sustained virological response to antiviral therapy
Faculty of Medicine, Department of Microbiology, Kuwait University, Safat, Kuwait. Journal of Medical Virology
(Impact Factor: 2.35).
04/2009; 81(4):610-8. DOI: 10.1002/jmv.21396
A higher prevalence of glucose abnormalities has been reported in patients with hepatitis C virus (HCV) infection compared to patients with hepatitis B virus (HBV) infection. However, previous studies considered some confounding factors and ignored others, which might influence the comparative risk assessment between HBV and HCV infections. Fasting plasma glucose concentration, severity of liver disease and viral load were determined in 220 patients with HCV genotype 4 infection, and 200 patients with HBV infection. Patients completing antiviral therapy were followed-up, and the fasting plasma glucose levels were determined in patients with and without sustained virological response. The prevalence of glucose abnormalities in HCV infection (41%) was significantly higher than that in HBV infection (16%). However, when controlling the severity of liver disease and other risk factors, the prevalence of glucose abnormalities in patients with HCV infection was comparable to that in patients with HBV infection. After attaining of sustained virological response, a decrease of the median fasting plasma glucose value was observed only in chronic hepatitis C. In the group of patients with normal fasting plasma glucose levels, an association of nonsustained virological response with the development of impaired fasting glucose was only observed in chronic hepatitis C. The severity of liver disease was a common predictor of impaired fasting glucose in hepatitis B and C infections. These results indicate that high prevalence of glucose abnormalities can be associated with HBV- and HCV-related liver disease, and that clearance of HCV, but not HBV, may improve glucose metabolism.
Available from: Hui-Ying Rao
- "The proportions of patients with normal glucose baseline were 40.34%. Of these studies, two did not report the proportion of HCV genotype1 , . The prevalence rate of infection with genotype 1 was 72.55%, ranging between 37.5–100%. "
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ABSTRACT: There is a significant association between effects of interferon-alpha treatment and the risk of developing hyperglycemia in patients with chronic hepatitis C virus (HCV) infection. The objective of this systematic review and meta-analysis on the basis of published observational studies was to estimate risk of hyperglycemia in chronic HCV patients who had acquired sustained virological responses (SVR) compared to those without SVR.
We identified eligible studies by searching the relevant databases, including PubMed, Embase, and Google, for papers published between January 1990 and April 2011. The selection of eligible papers was carried out using a scoring system based on guidelines and inclusion criteria that were established before the articles were identified. Heterogeneity across studies was determined and the meta-analysis was performed following standard guidelines.
Eleven eligible studies provided data of the incidence of hyperglycemia in chronic hepatitis C patients with SVR in comparison with patients without these conditions. The results demonstrated that SVR was associated with a lower risk of hyperglycemia (odds ratio = 0.497, 95% confidence interval 0.421-0.587, p<0.001), and there was no evidence of any substantial between-study heterogeneity (I(2) = 24.4%, p>0.1). Results of meta-regression showed patients with different baseline glucose (normal vs. abnormal) and patients with co-infected HIV (presence vs. absence) as the sources of low heterogeneity (p<0.15).The lowest risk of hyperglycemia was described in patients with normal glucose baseline (OR = 0.402, 95%CI 0.297-0.543, p<0.001). This is the first systematic review and meta-analysis performed to examine the association between SVR and risk of hyperglycemia in patients with HCV infection. Our meta-analysis suggests that SVR reduce the risk of developing glucose abnormalities, especially in patients with normal glucose baseline.
PLoS ONE 06/2012; 7(6):e39272. DOI:10.1371/journal.pone.0039272 · 3.23 Impact Factor
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ABSTRACT: This work first briefly discusses complexity and complex systems. Then it points out that a virtual enterprise is an open complex giant system and in essence a certain result of enterprise's adaptation to the environmental changes. The problems in enterprise cooperation are studied, then the framework of metasynthetic engineering platform for virtual enterprise is given to facilitate enterprise cooperation and management. The method and process of decision making for virtual enterprise are discussed. The key feature of this platform - human-machine cooperation - is also analyzed.
Computer Supported Cooperative Work in Design, 2004. Proceedings. The 8th International Conference on; 06/2004
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ABSTRACT: The aim of this study was to investigate the effect of interferon (IFN)-alpha treatment on glucose metabolism in children with chronic hepatitis B (CHB). Forty children with CHB received IFN 10 MU/m2 for six months. Oral glucose tolerance test, anti-insulin and anti-glutamic acid decarboxylase (GAD) antibody, fasting plasma C-peptide and insulin (FPI), postprandial insulin, homeostasis model assessment of insulin resistance (HOMA-IR), HOMA-cell, and glucose/insulin ratio (G/I) were measured before and after treatment. The last four parameters were also evaluated in healthy controls (n=42). In patients, fasting plasma glucose (FPG) and HOMA-IR levels were significantly lower than in controls (p = 0.001 and p = 0.020, respectively). There was a strong correlation between degree of liver disease and FPG. Two patients had hyperinsulinemia. HOMA-IR was suppressed in 7 patients enough to indicate increased sensitivity. FPI of 13 patients and HOMA-cell of 9 patients were lower than the minimum level of controls, features compatible with beta-cell hypofunction. Frequency of glucose metabolism abnormalities was not different before and after therapy. After therapy, only 1 patient developed anti-GAD antibody, and FPI of 8 children and HOMA-cell level of 9 children were lower than the minimum level of controls. Hyperinsulinemia was persistent in the same patients. We demonstrated that HBV-infected children had insulin sensitivity; however, no adverse effects of IFN on glucose homeostasis were seen.
The Turkish journal of pediatrics 01/2010; 52(6):594-601. · 0.43 Impact Factor
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