Glucose Metabolism Changes in Patients with Chronic Hepatitis C Treated with Direct Acting Antivirals
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...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2018/6095097 |
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| author | Sylvia Drazilova Martin Janicko Lubomir Skladany Pavol Kristian Marian Oltman Maria Szantova Dusan Krkoska Eva Mazuchova Lubica Piesecka Veronika Vahalova Marek Rac Ivan Schreter Ladislav Virag Tomas Koller Adriana Liptakova Miriam Ondrasova Peter Jarcuska |
| author_facet | Sylvia Drazilova Martin Janicko Lubomir Skladany Pavol Kristian Marian Oltman Maria Szantova Dusan Krkoska Eva Mazuchova Lubica Piesecka Veronika Vahalova Marek Rac Ivan Schreter Ladislav Virag Tomas Koller Adriana Liptakova Miriam Ondrasova Peter Jarcuska |
| author_sort | Sylvia Drazilova |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-df33a1c69b4f4e7892e384221b2e50f3 |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-df33a1c69b4f4e7892e384221b2e50f32025-02-03T05:48:38ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972018-01-01201810.1155/2018/60950976095097Glucose Metabolism Changes in Patients with Chronic Hepatitis C Treated with Direct Acting AntiviralsSylvia Drazilova0Martin Janicko1Lubomir Skladany2Pavol Kristian3Marian Oltman4Maria Szantova5Dusan Krkoska6Eva Mazuchova7Lubica Piesecka8Veronika Vahalova9Marek Rac10Ivan Schreter11Ladislav Virag12Tomas Koller13Adriana Liptakova14Miriam Ondrasova15Peter Jarcuska16Department of Internal Medicine, Hospital Poprad, Banícka 803/28, Poprad, 05801, Slovakia1st Department of Internal Medicine, PJ Safarik University, Faculty of Medicine and L Pasteur University Hospital, Trieda SNP 1, Kosice, 04001, Slovakia2nd Department of Internal Medicine, FD Roosevelt University Hospital, Ludvíka Svobodu 1, Banska Bystrica, 97517, SlovakiaDepartment of Infectious Diseases and Travel Medicine, PJ Safarik Unversity, Faculty of Medicine and L Pasteur University Hospital, Rastislavova 43, Kosice, 04001, SlovakiaCenter for Gastroenterology and Hepatology Thalion, Tomášikova 50/C, Bratislava, 83104, Slovakia3rd Department of Internal Medicine, Commenius University, Faculty of Medicine and University Hospital, Limbová 5, Bratislava, 83305, SlovakiaDepartment of Infectious Diseases and Travel Medicine, Commenius University, Jesenius Faculty of Medicine and University Hospital, Štefanovičova 689/3, Martin, 03601, SlovakiaDepartment of Infectious Diseases and Travel Medicine, Commenius University, Jesenius Faculty of Medicine and University Hospital, Štefanovičova 689/3, Martin, 03601, SlovakiaDepartment of Infectious Diseases, Teaching Hospital Nitra, Špitálska 6, Nitra, 95001, SlovakiaDepartment of Infectious Diseases, Teaching Hospital Nitra, Špitálska 6, Nitra, 95001, SlovakiaDepartment of Internal Medicine, Teaching Hospital Nitra, Špitálska 6, Nitra, 95001, SlovakiaDepartment of Infectious Diseases and Travel Medicine, PJ Safarik Unversity, Faculty of Medicine and L Pasteur University Hospital, Rastislavova 43, Kosice, 04001, SlovakiaDepartment of Infectious Diseases and Travel Medicine, PJ Safarik Unversity, Faculty of Medicine and L Pasteur University Hospital, Rastislavova 43, Kosice, 04001, Slovakia5th Department of Internal Medicine, Commenius University, Faculty of Medicine and University Hospital, Ružinovská 6, Bratislava, 82606, SlovakiaDepartment of Microbiology, Commenius University, Faculty of Medicine and University Hospital, Špitálska 13, Bratislava, 81372, SlovakiaSaint Elisabeth University of Health and Social Sciences, Palackého 1, Bratislava, 81000, Slovakia1st Department of Internal Medicine, PJ Safarik University, Faculty of Medicine and L Pasteur University Hospital, Trieda SNP 1, Kosice, 04001, SlovakiaBackground 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.http://dx.doi.org/10.1155/2018/6095097 |
| spellingShingle | Sylvia Drazilova Martin Janicko Lubomir Skladany Pavol Kristian Marian Oltman Maria Szantova Dusan Krkoska Eva Mazuchova Lubica Piesecka Veronika Vahalova Marek Rac Ivan Schreter Ladislav Virag Tomas Koller Adriana Liptakova Miriam Ondrasova Peter Jarcuska Glucose Metabolism Changes in Patients with Chronic Hepatitis C Treated with Direct Acting Antivirals Canadian Journal of Gastroenterology and Hepatology |
| title | Glucose Metabolism Changes in Patients with Chronic Hepatitis C Treated with Direct Acting Antivirals |
| title_full | Glucose Metabolism Changes in Patients with Chronic Hepatitis C Treated with Direct Acting Antivirals |
| title_fullStr | Glucose Metabolism Changes in Patients with Chronic Hepatitis C Treated with Direct Acting Antivirals |
| title_full_unstemmed | Glucose Metabolism Changes in Patients with Chronic Hepatitis C Treated with Direct Acting Antivirals |
| title_short | Glucose Metabolism Changes in Patients with Chronic Hepatitis C Treated with Direct Acting Antivirals |
| title_sort | glucose metabolism changes in patients with chronic hepatitis c treated with direct acting antivirals |
| url | http://dx.doi.org/10.1155/2018/6095097 |
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