Frequency of Insulin Resistance Among Hepatitis C Virus Patients With or Without Oesophageal Varices

Ashraf Metwally; Waseem M. Seleem; Nagwa Shawky

Volume : IV, Issue : X, October - 2014

Frequency of Insulin Resistance Among Hepatitis C Virus Patients With or Without Oesophageal Varices

Ashraf Metwally, Waseem M. Seleem, Nagwa Shawky

Abstract :

Background: Insulin resistance (IR) is directly associated with the severity of fiosis in chronic hepatitis C virus (HCV) patients. HCV associated with IR may cause enhanced hepatic steatosis, resistance to anti&ndash;viral treatment, faster progression of hepatic fiosis and cirrhosis with development of portal hypertension and oesophageal varices (OV). Aim of the work: The aim of this study is to estimate the frequency of IR among patients with HCV related cirrhosis with or without OV in an attempt to clarify the role of IR as a risk factor for developing OV in cirrhotic patients. Patients and methods: This study was performed on 120 patients with HCV related cirrhosis; 60 of them had endoscopic evidence of OV and 60 without OV. All patients included in this study were subjected to full history taking, thorough physical examination, laboratory investigations (complete blood count, liver function tests, anti&ndash; HCV antibodies, PCR for HCV, lipid profile, fasting and post prandial blood glucose, fasting insulin level with calculation of Homeostasis Model Assessment (HOMA) test to assess insulin sensitivity of the patients), abdominal ultrasonography and Esophagogastroduodenoscopy (EGD). Results: The frequency of IR was significantly higher among OV patients when compared to non&ndash;OV patients (61.7% vs 33.3% P&lt;0.001). The mean HOMA test value was significantly higher in OV patients than non&ndash; OV patients (3.41&plusmn;0.96 vs 2.49&plusmn;0.88 P&lt;0.001). Patients with IR had significantly higher frequency of large OV (grade 3 and 4) than patients with normal insulin sensitivity (35.1% and 27% vs 17.4% and 4.3% P=0.01). Conclusion: Patients with OV secondary to HCV&ndash;related cirrhosis had higher frequency of IR when compared to those without OV. Patients with IR had larger OV than those with normal insulin response.