ABSTRACT
HCV mainly affects the liver, but also several tissues outside the liver have been reported to be involved, resulting in a wide spectrum of extrahepatic manifestations. Several clinical studies have suggested a possible link between chronic hepatitis caused by hepatitis C [HCV] and the development of diabetes mellitus. We investigated the association between liver fibrosis and glucose intolerance in HCV-infected patients by measuring insulin sensitivity and beta-cell function. Untreated 38 chronic HCV-infected nondiabetic patients were recruited into this study [anti-HCV+]. Eighteen patients with chronic hepatitis other than HCV infection served as the control group [anti-HCV-]. We evaluated insulin sensitivity and beta-cell function of all patients in a fasting state [homeostasis model assessment of insulin resistance [HOMA-R] and homeostasis model assessment of beta-cell function [HOMA-beta]] and after an oral load of 75g glucose [whole -body insulin sensitivity index [WBISI] and delta-insulin/ delta-glucose 30]. For all included patients; histopathological changes in liver biopsies were evaluated. Severe fibrosis was a main factor associated with insulin resistance. There were significant differences in both HOMA-R [P< 0.01] and WBISI [P<0.05] between patients with mild fibrosis [N=17] and those with severe fibrosis [N=21]. Although HOMA-beta was increased significantly in the subjects with severe fibrosis compared with those with mild fibrosis [P<0.05], delta-insulin/ delta-glucose 30 showed no significant difference in stage of liver fibrosis. Last results suggest an uncertain association between liver fibrosis and beta cell function. Our findings suggest that the development of liver fibrosis is associated with insulin resistance in HCV-infected patients