Association between insulin resistance, metabolic syndrome, and duration of hepatitis C in Egyptian patients

• Published in: The Egyptian journal of internal medicine Vol. 25; no. 4; pp. 213 - 217
• Main Authors: Zakaria, Ebtissam, Fayad, Tarek, Rizk, Mary N., Ghanem, Nashwa S., Kamal, Maisa
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-10-2013; Springer Nature B.V; SpringerOpen
• Subjects: Hepatitis C; Hepatitis C virus, homeostasis model assessment-insulin resistance, insulin resistance, metabolic syndrome; Insulin resistance; Internal Medicine; Medicine & Public Health; Metabolic syndrome; Original Article; metabolic syndrome; hepatitis C virus; homeostasis model assessment-insulin resistance; insulin resistance
• ISSN: 1110-7782; 2090-9098
• DOI: 10.4103/1110-7782.124987

Background
Chronic hepatitis C virus (HCV) infection affects around 170 million individuals worldwide. Egypt has one of the highest prevalence of patients with HCV worldwide. A higher prevalence of insulin resistance (IR) is found in this population.
Aim
The aim of this work was to study the relation between IR, metabolic syndrome (MS), and hepatitis C in nondiabetic patients and to assess their relation to the duration of HCV infection.
Patients and methods
This was a cross-sectional study of 50 participants matched for age (49 ± 7.6 years), sex, and BMI. These participants were divided into three groups: 20 controls, 15 patients with HCV for less than 10 years’ duration, and 15 patients with HCV for more than 10 years. We assessed patients for MS according to the AACE diagnostic criteria. Fasting and postprandial insulin levels were also assessed. IR was evaluated using the homeostasis model assessment-insulin resistance (HOMA-IR) equation.
Results
There was a statistically significant difference in HOMA-IR levels between controls (median 0.43 μU/ml) and those with HCV for more than 10 years (median 0.75 μU/ml;
P
= 0.001) as well as those with HCV for less than 10 years (median 0.89 μU/ml;
P
= 0.001). There was no significant difference in HOMA-IR levels between both groups of HCV (
P
= 0.8). The increase in the HOMA-IR test values was mainly because of increased fasting insulin levels in both groups because of the significant positive correlation between HOMA-IR and fasting insulin in patients with chronic HCV less than and those more 10 years’ duration (
r
= 0.902,
r
= 1, respectively;
P
= 0.001 in both groups). MS was found in four of 15 patients in each group of patients; yet, none of the controls fulfilled the diagnosis criteria.
Conclusion
MS and IR are significantly higher in Egyptian HCV patients when compared with normal controls irrespective of the duration of HCV.