ABSTRACT
Background and aim of the work: HCV infection causes serious liver diseases including liver cirrhosis and liver cancer. It can also cause some extrahepatic diseases like diabetes mellitus. We aimed in this study to detect glucose abnormalities in patients with chronic hepatitis C and liver cirrhosis
Subjects and methods: the study was conducted on 70 subjects, 60 of them were HCV +ve and 10 apparently healthy volunteers as control. Patients were grouped into four groups. Group l: included 15 chronic hepatitis C patients[12 males, 3 females; mean age 46 +/- 8.0 years. Group 2: included 15 patients with Child A class, 9 males and 6 females with mean age 49 +/- 5.2 years. Group 3: included 15 patients with Child class B [7 males and 8 females with mean age 52.5 +/- 7.6 years. Group 4: included 15 patients with Child C class [9 males and 6 females with mean age 48.4 +/- 7.1 years]. Complete history and clinical examination, abdominal ultrasound were done. Liver function tests, fasting and postprandial blood glucose, renal function tests. HCV Ab, HBsAg, HCV RNA were done. Serum Insulin levels and C-peptide were measured by ELISA method
Results: body weight, body mass index [BMI], waist to hip ratio [WHR] in patients with chronic hepatitis C and cirrhotics were not different from the control group. 31.6% of patients were diabetics, 45% of patients had impaired glucose tolerance and 23.4% of patients had normal blood glucose. There was highly significant increase in both c-peptide and blood insulin levels in diabetic patients when compared to patients with impaired glucose tolerance and patients with normal blood glucose with p value < 0.0001
Conclusions: hyperinsulinemia and increased levels of serum C-peptide were found to be significantly more prevalent in chronic HCV patients. HCV-related liver diseases have great liability to develop disordered glucose homeostasis. Hyperinsulinemia and peripheral insulin resistance is one of the most important factors that underlie pathogenesis of hepatogenic diabetes