Insulin Resistance Among HCV Infected Liver Cirrhotic Patients With and Without Hepatocellular Carcinoma

Background: Hepatitis C virus infection is one of the most serious global health problems and major causes of chronic liver disease Egypt has the highest prevalence of HCV worldwide with approximately 20% of total population. HCV has been identified as a cause of metabolic syndrome that includes dyslipidemia diabetes and insulin resistance. HCV is the major risk factor for hepatocellular carcinoma development worldwide. Aim of the work: this study aimed at determining the frequency of insulin resistance in patients with chronic HCV induced liver cirrhosis and in patients with HCV-associated HCC. Insulin resistance in Egyptian patients infected with HCV genotype 4 has a role in predicting hepatocellular carcinoma. Patients and methods: 352 patients were included. Patients were divided into two groups. Group I included 176 patients; 120 males and 56 females with post-hepatitis C virus cirrhosis, Child grade A and B without HCC. Group II included 176 patients; 136 males and 40 females with post-hepatitis C virus cirrhosis, Child grade A and B with HCC. Fasting serum insulin level and homeostasis model assessment (HOMA) were estimated for all patients. Values were compared using appropriate statistical tests. Results: there was a highly significant statistical increase in group II compared with group I as regard fasting insulin (13.52±7.32 vs 10.9±6.107), HOMA-IR score(3.51±1.43 vs 2.72±1.14) and degree of IR ( a total of 63:6% of patients of group II vs 44.3% of patients of group I with moderate and severe degrees of IR). Conclusion: IR may be a risk factor for development of HCC among HCV infected cirrhotic patients.