Evaluation of some risk factors affecting insulin resistance in diabetic patients

BACKGROUND: The higher prevalence of Diabetes mellitus(DM) and Insulin resistance(IR) in patients with Hepatitis C Virus(HCV)infection was accompanied with increased expression of Cytochrome P450 2E1 ( CYP2E1). This study was designed to evaluate the relation between diabetes and HCV infection by estimating some risk factors (body weight, age & sex), biochemical parameters (Tumor Necrosis Factor Alpha (TNF-?) level, lipid profile, Glutathione reduced(GSH) concentration, liver Aspartate Amino transferase (ASAT) activity, liver Alanine Amino Transferase (ALAT) activity,Creatinine level, blood Urea nitrogen (BUN) level ) and molecular parameters. Methods: Fifty patients were divided into five groups each containing ten patients Group1; Control group included diabetic patients with normal insulin resistance level, Group 2; included diabetic patients with high level of insulin resistance, Group 3; included diabetic patients with high level of insulin resistance & positive hepatitis c virus, Group 4; included diabetic patients with high levels of both insulin resistance and TNF-?, Group 5; included diabetic patients with high level of insulin resistance and have coronary heart diseases. Results: Patients of diabetic HCV infected-group were significantly older and had higher serum ASAT and ALAT levels (P<0.01). The presence of hepatitis c virus in the diabetic patients in group (3) (gp.3) made a highly significant increase in the insulin resistance in compared to the control group(1), diabetic HCV patients have significantly high of soluble TNF-? (P<0.01) and in BUN levels in compared to control group (1), presence of hepatitis c virus in the diabetic patients did not show a significant change (P>0.05) in creatinine level in comparison to control group (1),a highly significant reduced levels of serum GSH, increased expression of CYP2E1 in HCV infected patients. Conclusion: Diabetic patients with HCV infection showed a significantly higher level of IR , TNF-? and increased expression of Cytochrome P450 2E1 ( CYP2E1) than those without HCV infection.