الفهرس | Only 14 pages are availabe for public view |
Abstract This study was conducted on 50 subjects who were classified into 25 patients who were non responders to treatment and achieved Sustained Virological Response (SVR) at 12 weeks on retreatment and 25 patients who were non responders to treatment and also failed to attain Sustained Virological Response (SVR) at 12 weeks on retreatment. All subjects were evaluated at the beginning of the study and 6 months later by: Insulin resistance was calculated through the HOMA method as follows: HOMA = fasting serum insulin (µu/ml) X serum glucose (mmol/dL) / 22.5. Patients were categorized as insulin resistant if HOMA was greater than 2 and diabetes if greater than 4. PCR for all patients with chronic hepatitis C and other liver function tests were done. The prevalence of insulin resistance is significantly different in the two groups. In chronic hepatitis C with failure on retreatment G2 insulin resistance increased from 5 cases (20%) to 11 cases (44%), and the other 5 cases of them (20%) developed DM, but in patients of chronic hepatitis C who achieved SVR at 12 weeks G1, 12 cases of insulin resistance pretreatment and after 6 months were as follows: 3 cases became non-insulin resistant and 2 cases became insulin resistant and 2 cases developed DM and 5 cases had no changes (still insulin resistant). Other 13 cases that were non-insulin resistant pretreatment and after 6 months were still non-insulin resistant. The two patients who developed DM after 6 months of therapy were insulin resistant before treatment. So development of DM and increase of insulin resistance was significantly higher with failure to respond to treatment reflecting most probably direct effect of HCV and no effect of therapy. In correlation between HOMA-IR and studied parameters we found highly significant relation between HOMA IR and liver enzymes, lipid and significant relation between HOMA IR and BMI, waist circumference. The prevalence of insulin resistance is significantly higher in HCV patients and it is improved with successful antiviral therapy. |