Whole-body Insulin Resistance is Associated with Elevated Serum α-fetoprotein Levels in Patients with Chronic Hepatitis C
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概要
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Objective Little is known about the relationship between elevated serum α-fetoprotein (AFP) levels and insulin resistance, which adversely influence the clinical course of chronic hepatitis C (CHC). Therefore, we investigated the association between serum AFP and insulin resistance in patients with CHC. Methods We retrospectively investigated 300 patients with CHC without hepatoma who underwent liver biopsies and oral glucose tolerance tests. Patients taking antidiabetic drugs were excluded. We analyzed factors associated with elevated AFP levels (≥10.0 ng/mL) in 265 eligible patients. Twenty patients with a homeostasis model assessment for insulin resistance value of ≥2.0 and a whole-body insulin sensitivity index of <5.0 received prospective lifestyle intervention. Results A univariate analysis showed that the body mass index, platelet count, levels of albumin, aspartate aminotransferase, alanine aminotransferase and γ-glutamyl transpeptidase, glucose metabolism, hepatic inflammation, fibrosis and steatosis were associated with elevated AFP levels. In a multivariate analysis, a platelet count of <15×104 /μL, aspartate aminotransferase level of ≥50 IU/L, γ-glutamyl transpeptidase level of ≥35 IU/L, whole-body insulin sensitivity index of <5.0 and stage 3-4 fibrosis were independently associated with an elevated AFP level. A Bayesian Network analysis showed that the aspartate aminotransferase level, whole-body insulin sensitivity index and hepatic fibrosis were directly associated with an elevated AFP level. The lifestyle intervention significantly improved the serum AFP level, homeostasis model assessment for insulin resistance and whole-body insulin sensitivity index. Conclusion Whole-body insulin resistance is associated with an elevated serum AFP level in patients with CHC. Lifestyle interventions targeting insulin resistance can reduce the serum AFP level and may ameliorate the clinical course of CHC.
- 社団法人 日本内科学会の論文
著者
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Mizuta Toshihiko
Department Of Internal Medicine And Gastrointestinal Endoscopy Saga Medical School
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Kawaguchi Yasunori
Department Of Internal Medicine And Gastrointestinal Endoscopy Saga Medical School
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Ozaki Iwata
Department Of Internal Medicine Faculty Of Medicine Saga University
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Isoda Hiroshi
Department Of Agricultural And Resource Economics Faculty Of Agriculture Kyushu University
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Iwane Shinji
Department Of Internal Medicine Saga Medical School
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KUWASHIRO Takuya
Department of Internal Medicine, Saga Medical School
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Motomura Yoichi
National Inst. Advanced Industrial Sci. And Technol. Tokyo Jpn
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Anzai Keizo
Department Of Endocrinology And Diabetes Mellitus School Of Medicine Fukuoka University
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Eguchi Yuichiro
Department Of General Medicine Saga Medical School
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OEDA Satoshi
Department of Hepato-Biliary-Pancreatology, Saga Prefectural Hospital Koseikan
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TAKAHASHI Hirokazu
Department of Agricultural Chemistry, Faculty of Agriculture, Tohoku University
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Kawaguchi Yasunori
Department of Internal Medicine, Saga Medical School, Japan
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Sakurai Eiichi
National Institute of Advanced Industrial Science and Technology, Japan
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Ozaki Iwata
Department of Internal Medicine, Saga Medical School, Japan
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Eguchi Yuichiro
Department of Internal Medicine, Saga Medical School, Japan
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Takahashi Hirokazu
Department of Internal Medicine, Saga Medical School, Japan
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Kuwashiro Takuya
Department of Internal Medicine, Saga Medical School, Japan
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Anzai Keizo
Department of Internal Medicine, Saga Medical School, Japan
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Motomura Yoichi
National Institute of Advanced Industrial Science and Technology, Japan
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