Prevalence of fatty liver disease among type 2 diabetes mellitus patients and its relation to insulin resistance

A substantial proportion of the mortality in patients with type 2 diabetes mellitus [T2DM] is related to non-alcoholic fatty liver disease [NAFLD] and its complications. Insulin resistance is a major etiologic factor for the development of fatty liver. We aimed to study the prevalence of NAFLD among T2DM patients and its relation to insulin resistance. Patients with T2DM that were referred to a tertiary referral center in Tehran from February 2003 to August 2005 were evaluated. Patients with characteristic findings on ultrasonography were considered as having fatty Livers. The Homeostasis Model Assistant - Insulin Resistance [HOMA-IR] and Quantitative Insulin Sensitivity Check Index [QUICKI] were calculated as measures of insulin resistance. Of the 172 patients included in the study, 96 [55.8%] had evidence of fatty livers, 6 of which [3.5% of total] presented with elevated liver enzymes. BMI and triglyceride levels in the fatty liver group were significantly higher than patients with normal livers [p=0.002 and 0.036, respectively]. The HOMA-IR and QUICKI indexes were not significantly different between the two groups. Fatty liver is a common finding among T2DM patients. The degree of insulin resistance does not appear to be predictive of fatty liver among this population

[HCV in intravenous drug users]

Hepatitis C [HCV] is increasing worldwide including Iran. HCV is more prevalent among intravenous drug abusers [IDU], especially if imprisoned, mostly due to needle sharing. We determined the rate of HCV seropositivity among IDU prisoners and compared it with those of non prisoners. A cross-sectional survey was done on consenting IDU inhabiting two prisons and attending three rehabilitation centers in Tehran, Iran. A questionnaire was completed for each subject and 5mL blood drawn. The samples were kept at 2-8°C until the sera were separated and stored at -70°C. HCV Ab [ELISA 1, third generation, DIA. PRO, Italy] with a sensitivity and specificity of 98% was checked by a single technician. Chi-square, Fisher's exact test and multivariable analysis were used where appropriate. Four-hundred and sixty seven subjects [346 [74.1%] prisoners; 425 [91%] male] were enrolled. Overall 66% tested positive for HCV Ab [287 male [67.5%], 21 female [50%], p<0.02]. HCV seropositivity was higher among prisoners [78.3% vs. 30.6%, p<0.001] and older IDU [76.9% vs. 62.9%, p=0.002]. Multivariable analysis showed association between HCV seropositivity and imprisonment [OR= 9.32, 95%CI: 5.60- 15.51], sharing syringes [OR=2.00, 95%CI: 1.27-3.17], duration of intravenous drug use annually [OR=1.16, 95%CI: 1.08-1.24] and male sex [OR=4.18, 95%CI: 2.02- 8.67]. HCV is rather common among IDU prisoners. Imprisonment is an independent risk factor. The infected IDU going back to the community may be an important source of HCV. Taking effective strategies [high risk group education, provision of sterile syringes, identification and treatment of infected IDU] to reduce the risk of this public health problem is needed urgently

[HCV in intravenous drug users]

Hepatitis C [HCV] is increasing worldwide including Iran. HCV is more prevalent among intravenous drug abusers [IDU], especially if imprisoned, mostly due to needle sharing. We determined the rate of HCV seropositivity among IDU prisoners and compared it with those of non prisoners. A cross-sectional survey was done on consenting IDU inhabiting two prisons and attending three rehabilitation centers in Tehran, Iran. A questionnaire was completed for each subject and 5mL blood drawn. The samples were kept at 2-8°C until the sera were separated and stored at -70°C. HCV Ab [ELISA 1, third generation, DIA. PRO, Italy] with a sensitivity and specificity of 98% was checked by a single technician. Chi-square, Fisher's exact test and multivariable analysis were used where appropriate. Four-hundred and sixty seven subjects [346 [74.1%] prisoners; 425 [91%] male] were enrolled. Overall 66% tested positive for HCV Ab [287 male [67.5%], 21 female [50%], p<0.02]. HCV seropositivity was higher among prisoners [78.3% vs. 30.6%, p<0.001] and older IDU [76.9% vs. 62.9%, p=0.002]. Multivariable analysis showed association between HCV seropositivity and imprisonment [OR= 9.32, 95%CI: 5.60- 15.51], sharing syringes [OR=2.00, 95%CI: 1.27-3.17], duration of intravenous drug use annually [OR=1.16, 95%CI: 1.08-1.24] and male sex [OR=4.18, 95%CI: 2.02- 8.67]. HCV is rather common among IDU prisoners. Imprisonment is an independent risk factor. The infected IDU going back to the community may be an important source of HCV. Taking effective strategies [high risk group education, provision of sterile syringes, identification and treatment of infected IDU] to reduce the risk of this public health problem is needed urgently