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Redução da resistência à insulina após resposta virológica sustentada com agentes antivirais diretos: Nem toda população melhora

dc.contributor.authorde Andrade, Vanessa Gutierrez [UNESP]
dc.contributor.authorYamashiro, Fábio da Silva [UNESP]
dc.contributor.authorOliveira, Cássio Vieira [UNESP]
dc.contributor.authorMoreira, Alecsandro [UNESP]
dc.contributor.authorWinckler, Fernanda Cristina [UNESP]
dc.contributor.authorSilva, Giovanni Faria [UNESP]
dc.date.accessioned2019-10-06T16:09:49Z
dc.date.available2019-10-06T16:09:49Z
dc.date.issued2018-07-01
dc.identifierhttp://dx.doi.org/10.1590/s0004-2803.201800000-69
dc.identifier.citationArquivos de Gastroenterologia, v. 55, n. 3, p. 274-278, 2018.
dc.identifier.issn1678-4219
dc.identifier.issn0004-2803
dc.identifier.urihttp://hdl.handle.net/11449/188489
dc.description.abstractBackground – Hepatitis C virus (HCV) infection is a serious public health problem, that affects approximately 170 million people worldwide. Chronic HCV infection is associated with hepatic insulin resistance and an increased risk of diabetes HCV-infected patients has been well documented. Objective – To assess the homeostasis model assessment of insulin resistance (HOMA-IR) index in patients treated with direct acting antiviral (DAAs) medication in the sustained virological response (SVR), categorized by the presence or absence of cirrhosis. Methods – A prospective study was conducted. Data were collected at the beginning of treatment (t-base) and in the twelfth week after the completion of treatment (t-SVR12). The inclusion criteria were presence of: HCV infection (RNA-HCV positive), age ≥18 years, completion of DAAs’ therapy, and presence of diabetes with use of oral hypoglycemic agents. All samples were collected during the study period. The exclusion criteria were: presence of HBV/HIV co-infection, hepatocellular carcinoma at baseline, diabetic patients taking insulin and transplanted patients (liver/kidney). Fibrosis was assessed by hepatic elastog-raphy or biopsy (METAVIR). Cirrhosis was determined by clinical results or imaging. HOMA-IR was calculated as fasting insulin (μU/mL) × fasting glucose (mmol/L)/22.5) The patients were divided into two groups: the general study population (all patients, including the diabetic patients) and the special population (patients with normal values of HOMA-IR, which is >2.5, and without diabetes). The delta HOMA-IR value was calculated as: HOMA-IR at t-base – HOMA-IR at t-SVR12. For the descriptive statistical analysis, the paired t-test and generalized linear model assuming the log binding function were performed. A P value of < 0.05 was considered significant. Results – We included 150 patients, and 75 were cirrhotic. The mean age was 55.3±9.97 and body mass index was 27.4±5.18. Twenty-two (14.67%) were diabetic patients using oral hypoglycemic agents, and 17 (11%) were cirrhotic. In the general study population, the mean glucose and HOMA-IR values increased at t-SVR12, but insulin decreased. Delta HOMA-IR was negative at t-SVR12, but there was no significant difference. Excluding diabetic patients and those with normal HOMA-IR values (<2.5), mean glucose, insulin and HOMA-IR decreased at t-SVR12. Delta HOMA-IR decreased significantly at t-SVR12 (P: 0.02). Conclusion – In the general population, glucose and HOMA-IR values increased at t-SVR12, but insulin decreased. In the special population, glucose, insulin, HOMA-IR and Delta HOMA-IR decreased at t-SVR12.en
dc.format.extent274-278
dc.language.isoeng
dc.relation.ispartofArquivos de Gastroenterologia
dc.sourceScopus
dc.subjectAntiviral agents
dc.subjectHepatitis C
dc.subjectInsulin resistance
dc.titleInsulin resistance reduction after sustained virological response with direct acting antiviral: Not every population improvesen
dc.titleRedução da resistência à insulina após resposta virológica sustentada com agentes antivirais diretos: Nem toda população melhorapt
dc.typeArtigo
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.description.affiliationUniversidade Estadual Paulista (UNESP) Faculdade de Medicina Departamento de Clínica Médica
dc.description.affiliationUnespUniversidade Estadual Paulista (UNESP) Faculdade de Medicina Departamento de Clínica Médica
dc.identifier.doi10.1590/s0004-2803.201800000-69
dc.identifier.scieloS0004-28032018002300274
dc.rights.accessRightsAcesso aberto
dc.identifier.scopus2-s2.0-85058402536
dc.identifier.fileS0004-28032018002300274.pdf
unesp.author.orcid0000-0001-6129-7045[6]
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