BACKGROUND: Although it has been reported that hepatitis C virus (HCV) infection is associated with a significant decline in health-related quality of life (HRQOL), the underlying causes and mechanisms are still unknown. Insulin resistance (IR) is recognized as a distinct aspect of chronic HCV infection. Therefore, we attempted to identify the factors including IR indices that are related to the HRQOL of patients with chronic hepatitis C (CHC). METHODS: One hundred and seventy-five CHC patients (91 female, 84 male, mean age, 56.4 years) not using antidiabetic agents were included and underwent a 75-g oral glucose tolerance test (OGTT) and completed a self-administered HRQOL questionnaire, the Short Form 36 (SF-36), which is a well-validated questionnaire for assessing general QOL. Scale scores were standardized and summarized into physical and mental component summary (PCS and MCS). We investigated which clinical parameters, including homeostasis model assessment of insulin resistance (HOMA-IR), were associated with decline in PCS and MCS scores in CHC patients. RESULTS: There were no significant differences in clinical parameters between high and low MCS, but there were significant differences in age, sex, hemoglobin, liver fibrosis, OGTT pattern, and HOMA-IR between high and low PCS. Multivariate analysis showed that HOMA-IR >2 was independently associated with lower PCS (OR 2.92, p < 0.01). CONCLUSIONS: Our results suggest that impairment of HRQOL, especially physical domains, in CHC patients is associated with IR.
BACKGROUND: Although it has been reported that hepatitis C virus (HCV) infection is associated with a significant decline in health-related quality of life (HRQOL), the underlying causes and mechanisms are still unknown. Insulin resistance (IR) is recognized as a distinct aspect of chronic HCV infection. Therefore, we attempted to identify the factors including IR indices that are related to the HRQOL of patients with chronic hepatitis C (CHC). METHODS: One hundred and seventy-five CHCpatients (91 female, 84 male, mean age, 56.4 years) not using antidiabetic agents were included and underwent a 75-g oral glucose tolerance test (OGTT) and completed a self-administered HRQOL questionnaire, the Short Form 36 (SF-36), which is a well-validated questionnaire for assessing general QOL. Scale scores were standardized and summarized into physical and mental component summary (PCS and MCS). We investigated which clinical parameters, including homeostasis model assessment of insulin resistance (HOMA-IR), were associated with decline in PCS and MCS scores in CHCpatients. RESULTS: There were no significant differences in clinical parameters between high and low MCS, but there were significant differences in age, sex, hemoglobin, liver fibrosis, OGTT pattern, and HOMA-IR between high and low PCS. Multivariate analysis showed that HOMA-IR >2 was independently associated with lower PCS (OR 2.92, p < 0.01). CONCLUSIONS: Our results suggest that impairment of HRQOL, especially physical domains, in CHCpatients is associated with IR.
Authors: Hari S Conjeevaram; Abdus S Wahed; Nezam Afdhal; Charles D Howell; James E Everhart; Jay H Hoofnagle Journal: Gastroenterology Date: 2010-11-09 Impact factor: 22.682
Authors: I M Gralnek; R D Hays; A Kilbourne; H R Rosen; E B Keeffe; L Artinian; S Kim; D Lazarovici; D M Jensen; R W Busuttil; P Martin Journal: Am J Gastroenterol Date: 2000-12 Impact factor: 10.864
Authors: Herbert L Bonkovsky; Kristin K Snow; Peter F Malet; Carla Back-Madruga; Robert J Fontana; Richard K Sterling; Clark C Kulig; Adrian M Di Bisceglie; Timothy R Morgan; Jules L Dienstag; Marc G Ghany; David R Gretch Journal: J Hepatol Date: 2006-11-27 Impact factor: 25.083
Authors: Brennan M R Spiegel; Zobair M Younossi; Ron D Hays; Dennis Revicki; Sean Robbins; Fasiha Kanwal Journal: Hepatology Date: 2005-04 Impact factor: 17.425