Meta-analysis: impact of sustained virological response on insulin resistance during hepatitis C therapy

Aim: Previous studies have shown that sustained virological response to standard chronic hepatitis C therapy appears to be associated with insulin resistance, however, the discrete relationship remains controversial. This meta-analysis was designed to evaluate whether the achievement of sustained virological response interfered with insulin resistance in chronic hepatitis C patients undergoing treatment with pegylated interferon plus ribavarin. Methods: A systematic search for relevant studies of EMBASE and MEDLINE databases as well as bibliographies of retrieved articles published up to June, 2015 was carried out. Summary estimates were obtained using fixed-effects or random-effects models according to the heterogeneity analysis and subgroup analyses, publication bias tests were analyzed by STATA 12.0. Results: Five studies involving 576 chronic hepatitis C patients were identified. There existed a significant association between sustained virological response rate and improved insulin resistance (SMD: -0.32, 95% CI: -0.51 similar to-0.14). This significant association of sustained virological response and improved insulin resistance was also verified in the analysis for cut-off values of HOMA-IR < 3 (SMD: -0.35, 95% CI: -0.55 similar to 0.15, P=0.008), non diabetic patients (SMD: -0.30, 95% CI: -0.49 similar to-0.11, P=0.009) as well as 24 weeks of follow-up (SMD: -0.43, 95% CI: -0.71 similar to-0.15, P=0.003). Conclusion: The results of this meta-analysis suggests a highly related relationship between the achievement of sustained virological response and the reduced Homeostasis Model Assessment of insulin resistance in patients with hepatitis C treated with pegylated interferon and ribavarin.