Interferon-Alpha Reduces Insulin Resistance and Beta-Cell Secretion in Responders among Patients with Chronic Hepatitis B and C

This study aimed at elucidating the effects of interferon ( IFN)-alpha on glucose metabolism in patients with chronic hepatitis B and C infections. Twenty-eight biopsy-proven patients with chronic hepatitis B (ten cases) and hepatitis C (18 cases) were given IFN-alpha for a total of 24 weeks. The patients received a 75 g oral glucose tolerance test ( OGTT), glucagon stimulation test, tests for type 1 diabetes- related autoantibodies and an insulin suppression test before and after IFN-alpha therapy. Ten of the 28 patients responded to IFN-alpha therapy. Steady-state plasma glucose of the insulin suppression test decreased significantly in responders (13. 32 +/- 1.48 (S.E.M.) vs 11.33 +/- 1.19 mmol/l , P=0.0501) but not in non- responders (12.29 +/- 1.24 vs 11. 11 +/- 0.99 mmol/l, P=0.2110) immediately after completion of IFN-alpha treatment. In the oral glucose tolerance test, no significant difference was observed in plasma glucose in either responders (10.17 +/- 0.23 vs 10.03 +/- 0.22 mmol/l) or non- responders (10.11 +/- 0.22 vs 9.97 +/- 0.21 mmol/l) 3 months after completion of IFN-alpha treatment. However, significant differences were noted in C-peptide in both responders (2.90 +/- 0.13 vs 2.20 +/- 0.09 nmol /l, P=0.0040) and non-responders (2.45 +/- 0.11 vs 2.22 +/- 10.08 nmol/l, P=0.0287) before vs after treatment. The changes of C- peptide in an OGTT between responders and non-responders were also significantly different (P =0.0028), with responders reporting a greater reduction in C-peptide. No case developed autoantibodies during the treatment. In patients who were successfully treated with IFN-alpha, insulin sensitivity improved and their plasma glucose stayed at the same level without secreting as much insulin from islet beta-cells