title: Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection.
abstract: OBJECTIVE
  To elucidate the role of insulin resistance (IR) and serum adiponectin level in hepatocellular carcinoma (HCC) associated with chronic hepatitis C.
  
  
  METHODS
  Clinical and biochemical characteristics were collected from 165 consecutive patients with newly diagnosed HCC. Homeostasis model assessment of IR (HOMA-IR) and serum adiponectin level were investigated in 188 patients with different stages of hepatitis C virus (HCV) infection.
  
  
  RESULTS
  Among HCC patients, type 2 diabetics (DM) was more prevalent in HCV subjects (35.6%, n = 59) compared to hepatitis B virus (HBV; 12.7%, n = 63) or non-HBV, non-HCV cases (7.1%, n = 28). In patients with chronic hepatitis C, HCC subjects had higher blood sugar (P < 0.001), insulin level (P = 0.003) and HOMA-IR (P = 0.018) than those with chronic hepatitis and advanced fibrosis. Age, male sex and body mass index were significantly associated with serum adiponectin level, whereas HOMA-IR was not. Based on stepwise logistic regression analysis, age (OR: 1.124, P < 0.001), serum insulin level (OR: 1.585, P < 0.001), HOMA-IR (OR: 0.495, P = 0.001), DM (OR: 11.601, P = 0.002) and male sex (OR: 3.877, P = 0.016) were independently associated with HCC. This result was similar even if the diabetic subjects were excluded for analysis.
  
  
  CONCLUSIONS
  Insulin resistance measured by HOMA-IR, regardless of the presence of diabetes, is significantly associated with HCC development in patients with chronic HCV infection.
authors.affiliation: Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung 833, Kaohsiung, Taiwan, China. chh4366@yahoo.com.tw
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Hung
authors.forename: Jing-Houng
authors.initials: JH
authors.lastname: Wang
authors.forename: Tsung-Hui
authors.initials: TH
authors.lastname: Hu
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chen
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Chang
authors.forename: Yi-Hao
authors.initials: YH
authors.lastname: Yen
authors.forename: Yuan-Hung
authors.initials: YH
authors.lastname: Kuo
authors.forename: Ming-Chao
authors.initials: MC
authors.lastname: Tsai
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Lu
authors.forename: Chuan-Mo
authors.initials: CM
authors.lastname: Lee
mesh_terms: D052242:Adiponectin / Q000097:blood; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000378:metabolism; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications / Q000378:metabolism; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000150:complications / Q000378:metabolism; D008113:Liver Neoplasms / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D007328:Insulin
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