THE RELATIONSHIP BETWEEN INSULIN RESISTANCE AND HEPATITIS C VIRUS INFECTION IN EGYPTIAN PATIENTS

Document Type : Original Article

Authors

1 Zoology Department, Faculty of Science, Al-Azhar University, Cairo, Egypt.

2 Clinical Pathology Department, National Liver Institute, Monoufiya University, Egypt.

Abstract

Background: Chronic hepatitis C virus (HCV) infection is one of the most common problems in Egypt. The prevalence
of diabetes mellitus is associated with HCV infection, it has a relation with Homeostatic Model Assessment insulin resistance (HOMA-IR).
Objective: To investigate the impacts of HCV infection (with and without cirrhosis) on glucose metabolism and its relationif
any-with body mass index (BMI) in chronic HCV patients.
Patients and Methods: Sixty cases were involved in this study, they were classified into three groups; group I: 20 healthy
control, group II: 20 chronic HCV patients without cirrhosis and group III: 20 chronic HCV patients with cirrhosis. All groups were subjected to the following: full history taking, through clinical examination, fasting and post prandial blood glucose levels (FBG and PPG), assessment of fasting plasma insulin level was done by the immune-enzymatic method. Assessment of the insulin resistance state was done by Homeostatic Model Assessment (HOMA-IR) and calculation of BMI. In addition, liver function tests (ALAT, ASAT, ALP, total bilirubin, albumin, and prothrombin time) and Detection of anti-HCV was done by the 3rd generation ELISA test and confirmed by qualitative polymerase chain reaction (PCR).
Results: Cirrhotic patients were found to have significantly higher fasting plasma insulin levels, insulin resistance (HOMAIR), blood glucose (FBG and PPG) and lower synthetic liver functions (albumin and prothrombin time) than the control and non-cirrhosis groups. Cirrhotic and non-cirrhotic patients were found to have significantly higher serum bilirubin, ALAT and ASAT as compared to the control. However, non-cirrhotic patients were found to have significantly higher alkaline phosphatase (ALP) than the control and cirrhosis groups.
Conclusion: Chronic HCV infection with cirrhosis may be regarded as an independent risk factor for the development of
insulin resistance and type 2 diabetes. HCV with cirrhosis induces insulin resistance, the key step for glucose intolerance. The impacts of chronic HCV infection with cirrhosis on glucose metabolism should be recognized in clinical care centers and addressed in future studies.

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