Association between liver fibrosis and insulin sensitivity in chronic hepatitis C patients.
BACKGROUND
Several clinical studies have suggested a possible link between chronic hepatitis caused by hepatitis C virus (HCV) and the development of diabetes mellitus. We investigated the association between liver fibrosis and glucose intolerance in HCV-infected patients by measuring insulin sensitivity and beta-cell function.


METHODS
A total of 83 chronic HCV-infected patients were recruited into this study. We evaluated insulin sensitivity and beta-cell function of all patients in a fasting state (homeostasis model assessment of insulin resistance [HOMA-R] and homeostasis model assessment of beta-cell function [HOMA-beta]) and after an oral load of 75 g glucose (whole-body insulin sensitivity index [WBISI] and Delta-insulin/Delta-glucose 30).


RESULTS
In a multivariate analysis, severe fibrosis was the only independent factor associated with insulin resistance. There were significant differences in both HOMA-R (P= 0.0063) and WBISI (P= 0.0159) between patients with mild fibrosis (N = 34) and those with severe fibrosis (N = 49). Although HOMA-beta was increased significantly in the subjects with severe fibrosis compared with those with mild fibrosis (P= 0.0169), Delta-insulin/Delta-glucose 30 showed no significant difference in stage of liver fibrosis, suggesting an uncertain association between liver fibrosis and beta-cell function.


CONCLUSIONS
Our findings suggest that the development of liver fibrosis is associated with insulin resistance in HCV-infected patients.
Taura
Naota
N
The First Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan.
Ichikawa
Tatsuki
T
Hamasaki
Keisuke
K
Nakao
Kazuhiko
K
Nishimura
Daisuke
D
Goto
Takashi
T
Fukuta
Mariko
M
Kawashimo
Hiroshi
H
Fujimoto
Masumi
M
Kusumoto
Koichiro
K
Motoyoshi
Yasuhide
Y
Shibata
Hidetaka
H
Abiru
Norio
N
Yamasaki
Hironori
H
Eguchi
Katsumi
K
D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D005951:Glucose Tolerance Test; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D050417:Insulin-Secreting Cells / Q000502:physiology; D008103:Liver Cirrhosis / Q000097:blood* / Q000503:physiopathology* / Q000821:virology; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D007328:Insulin