title: Insulin resistance, steatosis, and fibrosis in Egyptian patients with chronic Hepatitis C virus infection.
abstract: OBJECTIVE
  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.
  
  
  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.
authors: Department of Tropical Medicine and Gastroenterology, Assiut University Hospital, Assiut, Egypt.
authors: Ahlam M
authors: AM
authors: Ahmed
authors: Magda S
authors: MS
authors: Hassan
authors: Alaa
authors: A
authors: Abd-Elsayed
authors: Huwayda
authors: H
authors: Hassan
authors: Ahmad F
authors: AF
authors: Hasanain
authors: Ahmed
authors: A
authors: Helmy
mesh_terms: D000328:Adult; D017677:Age Distribution; D001707:Biopsy, Needle; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015897:Comorbidity; D003906:Developing Countries; D004534:Egypt / Q000453:epidemiology; D005234:Fatty Liver / Q000175:diagnosis / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007150:Immunohistochemistry; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology*; D008111:Liver Function Tests; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D055815:Young Adult