ABSTRACT
Patients with chronic liver disease display disturbances of glucose metabolism which is more prevalent among patients with chronic HCV compared with those with other liver diseases and the general population, irrespective of whether cirrhosis is resent. Insulin resistance, a "prediabetic" abnormality of blood sugar, is a specific feature of chronic hepatitis C virus [HCV] infection. To evaluate the clinical utility of the adipokine hormone resistin a potential mediator in inflammatory processes as a biomarker of disease progression in HCV infected patients and to assess if it is involved in the pathogenesis of insulin resistance. The study included 60 HCV infected patients and 20 healthy subjects as control. All cases were recruited from Kasr El Ani Hospital. They were classified into 3 groups; group [I]: Included 20 cases of HCV infected patients with no liver cirrhosis; group [II]: Included 40 cases of HCV infected patients with liver cirrhosis, it was subdivided into three subgroups according to Child-Pugh classification which were [IIa]10 cases, [IIb] 15 cases and [IIc] 15 cases and group [III]: Control group included 20 healthy subjects who were matched with the studied patients as regard age, sex and body mass index. Abdominal ultrasonography, upper endoscopy [for patient groups only], liver function, complete blood picture, erythrocytes sedimentation rate [ESR], C-reactive protein [CRP], blood sugar, fasting insulin, fasting C-peptide with calculation of insulin sensitivity [IS] by the quantitative insulin sensitivity check index [QUICKI] and serum resistin levels were done for all participants. Serum resistin level showed statistically highly significant elevation in HCV infected patients compared with the matched control group [p<0.001] and also its level showed statistically significant differences in subgroups of group [II] being higher in patients presented with complication of liver cell failure [p<0.01]. Its serum level was inversely correlated with the hepatic synthetic function including albumin [r=-0.476, p<0.001] and prothrombin concentration [r=-0.346, p<0.001]. Also, a positive correlations between resistin and biomarkers of inflammation including CRP [r=0.305, p<0.004] and TLC [r=0.268, p<0.01] and insulin resistance parameters [C-peptide r=0.285, p<0.01] were detected, while resistin was inversely correlated with insulin sensitivity [QUICKI] [r=-0.289, p<0.05]. This study demonstrates that serum resistin level is elevated in patients with HCV related chronic liver disease and might be used as a biomarker for the clinical progression of the disease. The correlation of resistin to the insulin resistance [IR] present in such patients, may suggest its possible role in the pathogenesis of insulin resistance