Relationship between Level of Serum Tumor Necrosis Factors-a, Insulin Resistance and Type 2 Diabetes Mellitus in Chronic Hepatitis C Patients
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Relationship between Level of Serum Tumor Necrosis Factors-a, Insulin Resistance and Type 2 Diabetes Mellitus in Chronic Hepatitis C Patients,MUSTAFA M. RAGHEB, ADEL A. HASSAN, MAHMOUD M. SHEDED and BASSAM M. SALAMA
Abstract
Background: Chronic HCV is the most common cause of chronic liver disease and cirrhosis which causes insulin resistance (IR) and increased risk of type 2 diabetes mellitus (DM). IR in HCV patients predicts faster progression to fibrosis and cirrhosis that may culminate in liver failure and hepatocellular carcinoma, also predicts a poor response to antiviral therapy. The molecular mechanisms for the association between IR and HCV infection are not well defined and need for further studies for understanding these mechanisms. This study aimed to assess the relation between level of serum tumor necrosis factor-a (TNF-a) and insulin resistance (IR) and DM in HCV patients and to describe the characters of HCV patients with insulin resistance.
Patients and Methods: Study included 3 groups of patients: Group 1; included HCV patients without DM, group 2 included; HCV patients with diabetes, group 3; includes patients have DM alone. All patients were subjected to the following full clinical assessment, and calculation of BMI. Assessment of fasting plasma insulin level and TNF were done by the im-mune-enzymatic method. Assessment of the insulin resistance state was done by Homeostatic Model Assessment (HOMA-IR). Detection of anti-HCV was done by the 3rd generation ELISA test and confirmed by qualitative polymerase chain reaction.
Results: Chronic HCV patients with DM and without DM were found to have significantly higher fasting plasma insulin levels than the diabetic patients (p=0.03). HCV patients with diabetes were found to have significantly higher IR than HCV patients without DM and diabetic patients (p=0.001). Insig-nificant difference between level of serum TNF among three groups of patients (p=0.17). Insignificant difference in level of TNF in HCV patients with or without IR. Insignificant positive correlation between HOMA-IR and TNF.
Conclusion: Chronic HCV patients have significant IR, and significantly elevated fasting insulin level. Insignificant Positive correlation between HOMA-IR and TNF.