Insulin Resistance in Non-diabetic Patients of Chronic Hepatitis C

Overview

Journal Pak J Med Sci

Specialty General Medicine

Date 2013 Dec 20

PMID 24353540

Citations 5

Authors

Zareen Kiran

Bader Faiyaz Zuberi

Daniah Anis

Rashid Qadeer

Khalid Hassan

Salahuddin Afsar

Affiliations

Soon will be listed here.

Abstract

Objective: To determine insulin resistance in non-diabetic chronic hepatitis C patients using Homeostatic Model Assessment of Insulin Resistance (HOMA-IR).

Methodology: Patients having anti-HCV positive were included in this study. Patients with diabetes mellitus, thyroid disease, hyperlipidemias, hypercortisolism and infective diseases other than hepatitis C were excluded. Age, weight, height and absence of diabetes were documented. Fasting blood glucose and fasting insulin levels were done. Body mass index and insulin resistance was calculated using the formulas. Patients having insulin resistance using formula HOMA-IR>2.5 were labeled as insulin resistant. Data was analyzed using SPSS-18.

Results: One hundred and fifty five patients according to sample size estimation were enrolled, in whom HOMA-IR was calculated, the mean value was found to be 2.47 ±1.30. A total of 79 (51%) of patients had HOMA-IR more than 2.5 showing insulin resistance.

Conclusion: In a third world country like Pakistan, where there is a high prevalence of hepatitis C infection, the consequences of the disease are also very common. Insulin resistance was found in 51% of patients with chronic hepatitis C.

Citing Articles

Hepatocellular Carcinoma in Asia: A Challenging Situation.

Jafri W, Kamran M Euroasian J Hepatogastroenterol. 2020; 9(1):27-33.

PMID: 31988864 PMC: 6969322. DOI: 10.5005/jp-journals-10018-1292.

Abnormal expression of SIRTs in psoriasis: Decreased expression of SIRT 1-5 and increased expression of SIRT 6 and 7.

Fan X, Yan K, Meng Q, Sun R, Yang X, Yuan D Int J Mol Med. 2019; 44(1):157-171.

PMID: 31017270 PMC: 6559298. DOI: 10.3892/ijmm.2019.4173.

High prevalence of insulin resistance among Brazilian chronic hepatitis C patients.

Villar L, Caldas G, Scalioni L, Miguel J, Silva E, Marques V Arch Endocrinol Metab. 2018; 61(6):628-632.

PMID: 29412389 PMC: 10522051. DOI: 10.1590/2359-3997000000315.

Hepatitis C Virus, Insulin Resistance, and Steatosis.

Kralj D, Virovic Jukic L, Stojsavljevic S, Duvnjak M, Smolic M, Curcic I J Clin Transl Hepatol. 2016; 4(1):66-75.

PMID: 27047774 PMC: 4807145. DOI: 10.14218/JCTH.2015.00051.

Efficacy of adding metformin to pegylated interferon and ribavirin in treatment naïve patients with chronic hepatitis C: a randomized double-blind controlled trial.

Sharifi A, Mohammadi M, Fakharzadeh E, Zamini H, Zaer-Rezaee H, Jabbari H Middle East J Dig Dis. 2014; 6(1):13-7.

PMID: 24829699 PMC: 4005479.

References

Kawaguchi T, Sata M . Importance of hepatitis C virus-associated insulin resistance: therapeutic strategies for insulin sensitization. World J Gastroenterol. 2010; 16(16):1943-52. PMC: 2860071. DOI: 10.3748/wjg.v16.i16.1943. View

Khattab M, Eslam M, Sharwae M, Shatat M, Ali A, Hamdy L . Insulin resistance predicts rapid virologic response to peginterferon/ribavirin combination therapy in hepatitis C genotype 4 patients. Am J Gastroenterol. 2010; 105(9):1970-7. DOI: 10.1038/ajg.2010.110. View

Serfaty L, Capeau J . Hepatitis C, insulin resistance and diabetes: clinical and pathogenic data. Liver Int. 2009; 29 Suppl 2:13-25. DOI: 10.1111/j.1478-3231.2008.01952.x. View

Machado M, Cortez-Pinto H . Insulin resistance and steatosis in chronic hepatitis C. Ann Hepatol. 2009; 8 Suppl 1:S67-75. View

White D, Ratziu V, El-Serag H . Hepatitis C infection and risk of diabetes: a systematic review and meta-analysis. J Hepatol. 2008; 49(5):831-44. PMC: 2642971. DOI: 10.1016/j.jhep.2008.08.006. View

Imai K, Takai K, Nishigaki Y, Shimizu S, Naiki T, Hayashi H . Insulin resistance raises the risk for recurrence of stage I hepatocellular carcinoma after curative radiofrequency ablation in hepatitis C virus-positive patients: A prospective, case series study. Hepatol Res. 2010; 40(4):376-82. DOI: 10.1111/j.1872-034X.2009.00616.x. View

Negro F, Alaei M . Hepatitis C virus and type 2 diabetes. World J Gastroenterol. 2009; 15(13):1537-47. PMC: 2669937. DOI: 10.3748/wjg.15.1537. View

Deltenre P, Louvet A, Lemoine M, Mourad A, Fartoux L, Moreno C . Impact of insulin resistance on sustained response in HCV patients treated with pegylated interferon and ribavirin: a meta-analysis. J Hepatol. 2011; 55(6):1187-94. DOI: 10.1016/j.jhep.2011.03.010. View

Duseja A, Dhiman R, Chawla Y, Thumburu K, Kumar A, Das A . Insulin resistance is common in patients with predominantly genotype 3 chronic hepatitis C. Dig Dis Sci. 2009; 54(8):1778-82. DOI: 10.1007/s10620-009-0844-y. View

10.

Krotkiewski M . Role of muscle morphology in the development of insulin resistance and metabolic syndrome. Presse Med. 1994; 23(30):1393-9. View

11.

Kim E . Insulin resistance at the crossroads of metabolic syndrome: systemic analysis using microarrays. Biotechnol J. 2010; 5(9):919-29. DOI: 10.1002/biot.201000048. View

12.

Hui J, Sud A, Farrell G, Bandara P, Byth K, Kench J . Insulin resistance is associated with chronic hepatitis C virus infection and fibrosis progression [corrected]. Gastroenterology. 2004; 125(6):1695-704. DOI: 10.1053/j.gastro.2003.08.032. View

13.

Vasques A, Rosado L, Cassia GAlfenas R, Geloneze B . [Critical analysis on the use of the homeostasis model assessment (HOMA) indexes in the evaluation of the insulin resistance and the pancreatic beta cells functional capacity]. Arq Bras Endocrinol Metabol. 2008; 52(1):32-9. DOI: 10.1590/s0004-27302008000100006. View

14.

Negro F, Clement S . Impact of obesity, steatosis and insulin resistance on progression and response to therapy of hepatitis C. J Viral Hepat. 2009; 16(10):681-8. DOI: 10.1111/j.1365-2893.2009.01186.x. View

15.

Delgado-Borrego A, Jordan S, Negre B, Healey D, Lin W, Kamegaya Y . Reduction of insulin resistance with effective clearance of hepatitis C infection: results from the HALT-C trial. Clin Gastroenterol Hepatol. 2010; 8(5):458-62. PMC: 2856733. DOI: 10.1016/j.cgh.2010.01.022. View

16.

Maassen J, Romijn J, Heine R . Fatty acid-induced mitochondrial uncoupling in adipocytes as a key protective factor against insulin resistance and beta cell dysfunction: a new concept in the pathogenesis of obesity-associated type 2 diabetes mellitus. Diabetologia. 2007; 50(10):2036-41. PMC: 2039833. DOI: 10.1007/s00125-007-0776-z. View

17.

Hung C, Wang J, Hu T, Chen C, Chang K, Yen Y . Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection. World J Gastroenterol. 2010; 16(18):2265-71. PMC: 2868220. DOI: 10.3748/wjg.v16.i18.2265. View

18.

Westin J, Lagging M, Dhillon A, Norkrans G, Romero A, Pawlotsky J . Impact of hepatic steatosis on viral kinetics and treatment outcome during antiviral treatment of chronic HCV infection. J Viral Hepat. 2007; 14(1):29-35. DOI: 10.1111/j.1365-2893.2006.00777.x. View

19.

Persico M, Masarone M, La Mura V, Persico E, Moschella F, Svelto M . Clinical expression of insulin resistance in hepatitis C and B virus-related chronic hepatitis: differences and similarities. World J Gastroenterol. 2009; 15(4):462-6. PMC: 2653368. DOI: 10.3748/wjg.15.462. View

20.

Kawaguchi T, Taniguchi E, Itou M, Sumie S, Yamagishi S, Sata M . The pathogenesis, complications and therapeutic strategy for hepatitis C virus-associated insulin resistance in the era of anti-viral treatment. Rev Recent Clin Trials. 2010; 5(3):147-57. DOI: 10.2174/157488710792007257. View