Liver injury in diabetic patients with hepatitis C virus antibodies

ABSTRACT

Diabetes mellitus [DM] and chronic liver diseases are common allover the world Liver diseases could affect the carbohydrate metabolism and on the other hand, the liver could be affected by DM in the form of fatty liver or even fatty hepatitis. Objectives: The present study was designed 1] to determine the prevalence of hepatitis C virus antibodies [HCV-AB] in patients with DM [type II], 2] to elucidate the relationship between the possible liver injury and DM and HCV-Ab and 3] to investigate the relationship between HCV-Ab seropositive and markers of the glycometabolic status in diabetics. Methods: The study included a series of 109 patients with DM on oral hypoglycemic drugs, and 91 apparently healthy individuals as controls. Diabetics and controls are enrolled from patients attending the outpatient clinics at Suez Canal University Hospital. No one of the study patients had positive serum for HBsAg or ultrasound findings suggestive of cirrhosis. Sera from all study participants were screened for HCV-Ab, and alanine aminotransferase [ALT] levels Pre- and post-prandial glycaemia were determined by measurement of the fasting blood glucose [FBG] and response of blood glucose levels to 75 g oral glucose [PPG]. Level of fructosamine [FA] was used as an indicator of short-term blood glucose control Quantitative determination of insulin and C-peptide of insulin were carried out using immunoreactive-assay techniques. Results: HCV-Ab was positive in 26.6% of diabetics and 18.7% of non-diabetics. Diabetics had a significantly higher serum ALT level [18.8 +/- 13.9 lU/L] as compared with non-diabetics [15.3 +/- 9.6 lU/L] where P was < 0.05. In logistic regression analysis to detect the main predictors of the elevated ALT, it was found that the HCV-Ab seropositivity is the only significant predictor [P < 0.001], while the other factors [DM, obesity; age, sex] are not significant. It was found that there is no association between HCV-Ab seropositivity and the FBG, PPG. FA, insulin, and C-peptide concentrations in both diabetics and non-diabetics Conclusion: The observed liver damage in diabetics is associated with positive HCV-Ab and not associated with diabetes per se or obesity. HCV-Ab seropositivity does not affect glycemic state. glycemic control level, serum insulin and pancreatic reserve of insulin neither in diabetics nor in healthy individuals