ABSTRACT
Background: Hepatitis C virus [HCV] infection is a challenging health problem in Egypt. Esophageal varices are a major complication of it which may bleed and endanger patient's life
Aim of the work: to assess the relationship between type-2 DM and the development of gastroesophageal varices and explore the role of insulin resistance as a predictor of gastroesophageal varices
Patients and methods: This study included 100 patients with Child A, HCV-induced cirrhosis. They were divided into two main groups: Group A included 50 patients with type-2 DM, while Group B: included 50 non-diabetic which were subdivided into: Group B1: patients without DM but, with insulin resistance [IR] [32], and Group B2: patients without DM or IR [18]. All patients were subjected to full history taking, clinical examination, laboratory and imaging studies [abdominal ultrasound] and upper GI endoscopy
Results: The prevalence of esophageal varices in patients with Child A HCV-induced cirrhosis was 80%, elevated to 88% in patients with type-2 DM. Insulin resistance played the major role in development of esophageal varices. There are statistically significant elevated HOMA-IR score, lower platelet count/spleen diameter ratio and higher right liver lobe diameter/albumin ratio in patients with varices
Conclusion: Insulin resistance is a major contributor for development of esophageal varices in HCV induced cirrhosis. Platelet count/spleen diameter ratio, right liver lobe diameter/albumin ratio and insulin resistance measured by HOMA-IR are good predictors for the presence of esophageal varices