Meta-analysis: insulin resistance and sustained virological response in hepatitis C

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Meta-analysis: insulin resistance and sustained virological response in

hepatitis C

Alimentary Pharmacology and Therapeutics, 06/02/2011  Evidence Based Medicine

Clinical Article

Eslam M et al. – Elevated homeostasis model assessment of insulin

resistance(HOMA–IR) was associated with a lower cure rate of patients with

hepatitis C treated with Peg–IFN–(alpha)/ribavirin irrespective of genotype,

and the more difficult–to–treat cohort, the better the HOMA–IR prediction.

HOMA–IR is, as a surrogate marker of insulin resistance, susceptible to some

biases derived from both handling and interpretation.

Methods

• Relevant studies were identified by searching Medline and EMBASE.

• The authors identified 17 publications that addressed the influence of

insulin resistance on SVR.

• The random effect model of Der Simonian and Laird method were used for

heterogeneous studies using the Meta-Disc software 1.4, Madrid, Spain.

Results

• Normal insulin sensitivity was associated with a higher rate of SVR [odds

ratio (OR) 2.86 (95%CI: 1.97–4.16)] in comparison with insulin resistance.

• Moreover, in separate analysis by genotype selecting studies that used

HOMA-IR > 2 as cut-off defining insulin resistance, SVR was higher in patients

with HOMA-IR < 2 in all genotypes: HCV-1 [OR: 2.16 (95%CI: 1.51–3.08)],

HCV-2 & 3 [OR: 3.06 (95%CI: 1.06–8.82)] and HCV-4 [OR: 6.65(95%CI:

2.51–17.61)].

• Studies reporting no association between HOMA and SVR included easy-to-cure

cohorts, analysed variables strongly related with insulin resistance like body

mass index, steatosis, hyper (gamma)GT, age and fibrosis and reported

differences in handling and interpretation of HOMA-IR

[Guest guest]

http://www.mdlinx.com/gastroenterology/newsl-article.cfm/3623977/ZZ6806553679256\

39220014/?news_id=511 & newsdt=060211 & subspec_id=144

Meta-analysis: insulin resistance and sustained virological response in

hepatitis C

Alimentary Pharmacology and Therapeutics, 06/02/2011  Evidence Based Medicine

Clinical Article

Eslam M et al. – Elevated homeostasis model assessment of insulin

resistance(HOMA–IR) was associated with a lower cure rate of patients with

hepatitis C treated with Peg–IFN–(alpha)/ribavirin irrespective of genotype,

and the more difficult–to–treat cohort, the better the HOMA–IR prediction.

HOMA–IR is, as a surrogate marker of insulin resistance, susceptible to some

biases derived from both handling and interpretation.

Methods

• Relevant studies were identified by searching Medline and EMBASE.

• The authors identified 17 publications that addressed the influence of

insulin resistance on SVR.

• The random effect model of Der Simonian and Laird method were used for

heterogeneous studies using the Meta-Disc software 1.4, Madrid, Spain.

Results

• Normal insulin sensitivity was associated with a higher rate of SVR [odds

ratio (OR) 2.86 (95%CI: 1.97–4.16)] in comparison with insulin resistance.

• Moreover, in separate analysis by genotype selecting studies that used

HOMA-IR > 2 as cut-off defining insulin resistance, SVR was higher in patients

with HOMA-IR < 2 in all genotypes: HCV-1 [OR: 2.16 (95%CI: 1.51–3.08)],

HCV-2 & 3 [OR: 3.06 (95%CI: 1.06–8.82)] and HCV-4 [OR: 6.65(95%CI:

2.51–17.61)].

• Studies reporting no association between HOMA and SVR included easy-to-cure

cohorts, analysed variables strongly related with insulin resistance like body

mass index, steatosis, hyper (gamma)GT, age and fibrosis and reported

differences in handling and interpretation of HOMA-IR