Decoupled Glucose and Lipid Metabolic Recovery after Viral Clearance in Direct-Acting Antiviral-Treated HCV Patients: A 3-Year Prospective Cohort Study
Background/Aim: The recovery pattern of hepatitis C virus (HCV)-associated metabolic alteration after sustained virological response (SVR) following direct-acting antivirals (DAAs) remains elusive. Methods: A prospective cohort study of chronic HCV-infected (CHC) patients (n = 415) receiving DAAs (n...
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MDPI AG
2021-10-01
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| Online Access: | https://www.mdpi.com/2073-4409/10/11/2934 |
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| author | Heng Lee Rong-Nan Chien Li-Heng Pao Chia-Jung Kuo Po-Han Huang Ming-Ling Chang |
| author_facet | Heng Lee Rong-Nan Chien Li-Heng Pao Chia-Jung Kuo Po-Han Huang Ming-Ling Chang |
| author_sort | Heng Lee |
| collection | DOAJ |
| description | Background/Aim: The recovery pattern of hepatitis C virus (HCV)-associated metabolic alteration after sustained virological response (SVR) following direct-acting antivirals (DAAs) remains elusive. Methods: A prospective cohort study of chronic HCV-infected (CHC) patients (n = 415) receiving DAAs (n = 365) was conducted. Metabolic profiles were examined in SVR patients (n = 360) every 3–6 months after therapy and compared with those of sex- and age-matched controls (n = 470). Results: At baseline, of 415, 168 (40.5%) had insulin resistance (IR). The following were associated: levels of high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), HCV RNA, fibrosis-4 score, and interferon-λ3-rs12979860 genotype with total cholesterol (TC) levels; and TG levels and BMI with HOMA-IR. Over a 3-year follow-up, in SVR patients, BMI and TC levels and TG/HDL-C ratios increased from baseline, while HOMA-IR trended downward by 72 weeks after therapy and then increased. The increased HDL-C levels began to decrease after 72 weeks after therapy. TC and HOMA-IR were negatively associated with each other until 24 weeks after therapy. Earlier increases in BMI and decreases in HOMA-IR were noted in SVR patients with than in those without baseline IR. Compared with controls, in the subgroup without baseline IR, SVR patients had increased BMI and HOMA-IR levels. Metabolic profiles were similar between SVR patients and controls in the subgroup with baseline IR. Conclusions: In SVR patients treated with DAAs, the recovery of altered lipid and glucose metabolism was not coupled until 72-week post-therapy, when HOMA-IR reached its nadir. SVR patients with baseline IR recovered from HCV-associated metabolic alterations earlier than those without baseline IR. |
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| language | English |
| last_indexed | 2024-03-10T05:37:06Z |
| publishDate | 2021-10-01 |
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| series | Cells |
| spelling | doaj.art-23b88b3708994bc7bcaa0a9a98ee95bb2023-11-22T22:48:54ZengMDPI AGCells2073-44092021-10-011011293410.3390/cells10112934Decoupled Glucose and Lipid Metabolic Recovery after Viral Clearance in Direct-Acting Antiviral-Treated HCV Patients: A 3-Year Prospective Cohort StudyHeng Lee0Rong-Nan Chien1Li-Heng Pao2Chia-Jung Kuo3Po-Han Huang4Ming-Ling Chang5Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, TaiwanDepartment of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, TaiwanGraduate Institute of Health Industry Technology, Chang Gung University of Science and Technology, Taoyuan 33303, TaiwanDepartment of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, TaiwanDepartment of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, TaiwanDepartment of Medicine, College of Medicine, Chang Gung University, Taoyuan 333323, TaiwanBackground/Aim: The recovery pattern of hepatitis C virus (HCV)-associated metabolic alteration after sustained virological response (SVR) following direct-acting antivirals (DAAs) remains elusive. Methods: A prospective cohort study of chronic HCV-infected (CHC) patients (n = 415) receiving DAAs (n = 365) was conducted. Metabolic profiles were examined in SVR patients (n = 360) every 3–6 months after therapy and compared with those of sex- and age-matched controls (n = 470). Results: At baseline, of 415, 168 (40.5%) had insulin resistance (IR). The following were associated: levels of high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), HCV RNA, fibrosis-4 score, and interferon-λ3-rs12979860 genotype with total cholesterol (TC) levels; and TG levels and BMI with HOMA-IR. Over a 3-year follow-up, in SVR patients, BMI and TC levels and TG/HDL-C ratios increased from baseline, while HOMA-IR trended downward by 72 weeks after therapy and then increased. The increased HDL-C levels began to decrease after 72 weeks after therapy. TC and HOMA-IR were negatively associated with each other until 24 weeks after therapy. Earlier increases in BMI and decreases in HOMA-IR were noted in SVR patients with than in those without baseline IR. Compared with controls, in the subgroup without baseline IR, SVR patients had increased BMI and HOMA-IR levels. Metabolic profiles were similar between SVR patients and controls in the subgroup with baseline IR. Conclusions: In SVR patients treated with DAAs, the recovery of altered lipid and glucose metabolism was not coupled until 72-week post-therapy, when HOMA-IR reached its nadir. SVR patients with baseline IR recovered from HCV-associated metabolic alterations earlier than those without baseline IR.https://www.mdpi.com/2073-4409/10/11/2934HCVmetabolic alterationlipidHOMA-IRDAA |
| spellingShingle | Heng Lee Rong-Nan Chien Li-Heng Pao Chia-Jung Kuo Po-Han Huang Ming-Ling Chang Decoupled Glucose and Lipid Metabolic Recovery after Viral Clearance in Direct-Acting Antiviral-Treated HCV Patients: A 3-Year Prospective Cohort Study Cells HCV metabolic alteration lipid HOMA-IR DAA |
| title | Decoupled Glucose and Lipid Metabolic Recovery after Viral Clearance in Direct-Acting Antiviral-Treated HCV Patients: A 3-Year Prospective Cohort Study |
| title_full | Decoupled Glucose and Lipid Metabolic Recovery after Viral Clearance in Direct-Acting Antiviral-Treated HCV Patients: A 3-Year Prospective Cohort Study |
| title_fullStr | Decoupled Glucose and Lipid Metabolic Recovery after Viral Clearance in Direct-Acting Antiviral-Treated HCV Patients: A 3-Year Prospective Cohort Study |
| title_full_unstemmed | Decoupled Glucose and Lipid Metabolic Recovery after Viral Clearance in Direct-Acting Antiviral-Treated HCV Patients: A 3-Year Prospective Cohort Study |
| title_short | Decoupled Glucose and Lipid Metabolic Recovery after Viral Clearance in Direct-Acting Antiviral-Treated HCV Patients: A 3-Year Prospective Cohort Study |
| title_sort | decoupled glucose and lipid metabolic recovery after viral clearance in direct acting antiviral treated hcv patients a 3 year prospective cohort study |
| topic | HCV metabolic alteration lipid HOMA-IR DAA |
| url | https://www.mdpi.com/2073-4409/10/11/2934 |
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