title: The association between insulin resistance and hepatic fibrosis in patients with chronic hepatitis C: an observational, multicenter study in Turkey.
abstract: OBJECTIVE
  To evaluate the association between insulin resistance and hepatic fibrosis in patients with chronic hepatitis C.
  
  
  METHODS
  A total of 104 chronic hepatitis C patients were included in this non-interventional, open-label, observational, multicenter, cross-sectional study conducted at 20 gastroenterology clinics in Turkey. The primary end point was the correlation between stage of hepatic fibrosis and insulin resistance evaluated via the homeostasis model of assessment-insulin resistance index. Confounders of hepatic fibrosis and insulin resistance were the secondary end points.
  
  
  RESULTS
  The mean age of patients was 52.8 years; 65.4% were female. Type 2 diabetes was present in 6.8% and insulin resistance noted in 38.0% of patients. Further, 45.7% of the patients had mild (A0/A1) and the remaining had moderate/severe (A2/A3) hepatic necroinflammatory activity. Patient distribution according to Metavir fibrosis stage was as follows: F0/F1 (57.0%); F2 (6.5%); F3 (23.7%); and F4 (12.9%). A univariate analysis revealed significant positive correlations between Metavir fibrosis stage and insulin resistance (r=0.297; p=0.007). Logistic regression analysis showed that significant predictors of insulin resistance were high alanine transaminase levels (odds ratio, 0.97; 95% confidence interval, 0.944-0.997) and liver fibrosis stage (odds ratio, 0.114; 95% confidence interval, 0.021-0.607).
  
  
  CONCLUSIONS
  Our findings revealed significant associations between insulin resistance and hepatic fibrosis.
authors.affiliation: Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey. adokmeci@hotmail.com.
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Dökmeci
authors.forename: Yücel
authors.initials: Y
authors.lastname: Ustündağ
authors.forename: Saadettin
authors.initials: S
authors.lastname: Hulagu
authors.forename: Ilyas
authors.initials: I
authors.lastname: Tuncer
authors.forename: Meral
authors.initials: M
authors.lastname: Akdoğan
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Demirsoy
authors.forename: Seyfettin
authors.initials: S
authors.lastname: Köklü
authors.forename: Fatih
authors.initials: F
authors.lastname: Güzelbulut
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Doğan
authors.forename: Ali
authors.initials: A
authors.lastname: Demir
authors.forename: Mesut
authors.initials: M
authors.lastname: Akarsu
authors.forename: Hakan
authors.initials: H
authors.lastname: Yüceyar
authors.forename: Osman Cavit
authors.initials: OC
authors.lastname: Ozdoğan
authors.forename: Fatih
authors.initials: F
authors.lastname: Ozdener
authors.forename: Seda
authors.initials: S
authors.lastname: Erdoğan
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D005215:Fasting; D005260:Female; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications*; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008103:Liver Cirrhosis / Q000473:pathology* / Q000503:physiopathology* / Q000821:virology; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D014421:Turkey; D019562:Viral Load
chemical_list: D001786:Blood Glucose; D007328:Insulin; D012367:RNA, Viral; D000410:Alanine Transaminase