Relationship between insulin resistance, liver fibrosis and steatosis in non-diabetic non-obese chronic hepatitis C patients

ABSTRACT

Relationship between HCV and DM was documented in several studies. HCV through pro-inflammatory cytokines causes insulin resistance. Steatosis in HCV is a well known pathological feature. Interest in the last decade was turned into the possible link between insulin resistance and Steatosis and their effect on fibrosis progression was to study relationships between fibrosis, inflammation, Steatosis and insulin resistance in HCV patients. This study was conducted on 80 patients with HCV and 20 healthy controls. Participants were subjected to clinical examination, laboratory investigations [liver and kidney function tests, hepatitis markers, fasting glucose, insulin, and serum lipids], HOMA score estimation, BMI calculation and abdominal ultrasonography. Patients underwent liver biopsy and qualitative PCR for HCV RNA. showed higher HOMA score and fasting insulin levels in HCV patients than controls. A strong positive correlation was found between insulin resistance, fasting insulin levels and liver fibrosis in HCV patients. No correlation was found between insulin resistance and neither BMI nor age of patients. Prevalence of Steatosis in HCV patients biopsies was 93.75%. Significant correlation was found between fibrosis and Steatosis, and between insulin resistance and Steatosis. detection and treatment of insulin resistance in chronic hepatitis C patients are recommended to improve outcome of patients and decrease rate of progression of fibrosis