Thai Journal of Gastroenterology

Article :
The Degree of Insulin Resistance in Hepatitis C Infection

Author :
Jaruwat Yossombat, M.D.
Nattapong Kosachunhanan, M.D.
Lakkana Thaikruea, M.D.
Wittanee Na Chiang Mai, M.D.
Satawat Thongsawat, M.D.

Abstract :

Background: The prevalence of type 2 diabetes mellitus is higher in chronic hepatitis C infection with
significant higher degree of insulin resistance.  There are limited data of insulin resistance in Thai patients with chronic hepatitis C.

Aim: To compare the degree of insulin resistance in non-diabetic chronic hepatitis C patients with matched
healthy controls.

Patients and Methods: A case-control study was conducted, comprising 85 confirmed non-diabetic chronic hepatitis C patients who attended for blood donation at Chiang Mai University Hospital and 75 healthy
blood donors matched by age and gender.  The demographic and the clinical data were collected.  Biochemical tests were carried out.  Hepatic ultrasonography was performed in all chronic HCV cases, and was combined with clinical and biochemical tests for the exclusion of liver cirrhosis.  The degrees of insulin resistance as determined by the homeostasis model assessment (HOMA-IR) were compared between the two groups.

Results: Non-diabetic chronic HCV subjects had no significantly different degree of insulin resistance
when compared with matched healthy controls (1.638 +/- 1.359 vs 1.612 +/- 1.131, p = 0.894).  Using the BMI cut-off point of 23 for determining an overweight status for Asian populations, there were no differences of the HOMA-IR in BMI >23 between the two groups (2.27 +/- 1.50 vs 2.13 +/- 1.83, p=0.666).  There were significantly lower HOMAIR in HCV cases in BMI <23 compared with healthy subjects (0.86 +/- 0.51 vs 1.13 +/- 0.56, p = 0.027).

Conclusions: A significantly higher degree of insulin resistance in patients with hepatitis C may not be
the case in patients with a younger age of onset or a shorter duration of HCV infection.  A lower BMI may be
another possible explanation for the lower degree of insulin resistance in this type of patients.

[Thai J Gastroenterol 2005; 6(3): 137-143]

Keyword :
degree, insulin resistance, hepatitis C

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