Saudi Journal of Gastroenterology
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Year : 2011  |  Volume : 17  |  Issue : 4  |  Page : 245-251

Insulin resistance, steatosis, and fibrosis in Egyptian patients with chronic Hepatitis C virus infection

1 Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egypt
2 Department of Public Health and Community Medicine, Assiut University, Assiut, Egypt
3 Department of Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt

Correspondence Address:
Ahmed Helmy
Department of Tropical Medicine and Gastroenterology, 6th Floor, Assiut University Hospital, Post Code 71511, Assiut
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1319-3767.82578

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Background/Aim: Both nonalcoholic fatty liver disease (NAFLD) and chronic hepatitis C virus (HCV) infection are common in Egypt, and their coexistence is expected. There is controversy regarding the influence of NAFLD on chronic HCV disease progression. This study evaluates the effect of NAFLD on the severity of chronic hepatitis C (CHC) (necroinflammation and fibrosis) and assesses the relative contribution of insulin resistance syndrome to the occurrence of NAFLD in patients with chronic HCV infection. Patients and Methods: Untreated consecutive adults with chronic HCV infection admitted for liver biopsy were included in this study. Before liver biopsy, a questionnaire for risk factors was completed prospectively, and a blood sample was obtained for laboratory analysis. Results: Our study included 92 male patients. Their mean ± SD age and aspartate aminotransferase (AST) level were 42 ± 7.7 years (range 20-56) and 68 ± 41.7 U/L (range 16-214), respectively. The mean insulin level and insulin resistance index were 15.6 ± 18.3 mIU/mL (range 5.1-137.4) and 5.9 ± 15.2 (range 0.9-136.2), respectively. Fifty four percent of patients had steatosis and 65% had fibrosis. In multivariate analyses, steatosis was associated with insulin resistance and fibrosis was associated with high AST level, age ≥40 years, and steatosis. Conclusions: Steatosis is a histopathologic feature in >50% of patients with chronic HCV infection. Insulin resistance has an important role in the pathogenesis of steatosis, which represents a significant determinant of fibrosis together with high serum AST level and older age.

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