title: Significance of Hepatic Insulin Clearance in Patients with Chronic Hepatitis C and Non-alcoholic Fatty Liver Disease.
abstract: Objective Hyperinsulinemia plays an important role in the pathophysiological processes of chronic hepatitis C (CHC) and non-alcoholic fatty liver disease (NAFLD). However, there are few reports on hepatic insulin clearance in patients with these diseases. Methods A total of 74 CHC patients and 37 NAFLD patients were enrolled in this study. We evaluated their hepatic insulin clearance, insulin sensitivity and β-cell function with an oral glucose tolerance test. Results Hepatic insulin clearance in the patients with CHC was significantly correlated with platelets (r=0.271, p=0.020) and liver fibrosis (r=-0.234, p=0.045) and was significantly affected by both steatosis (mild: 0.157±0.078, severe: 0.114±0.053, p=0.024) and fibrosis (mild: 0.167±0.0857, severe: 0.125±0.052, p=0.010). There were no significant differences in (homeostasis model assessment) HOMA-β among steatosis and fibrosis stages. In the NAFLD patients, those with severe fibrosis had significantly reduced hepatic insulin clearance (mild: 0.135±0.045, severe: 0.098±0.031, p=0.013) and significantly increased HOMA-β (mild: 115.6±67.1, severe: 172.8±65.7, p=0.018) compared with the patients with mild fibrosis. Conclusion Liver fibrosis development is associated with hepatic insulin clearance in both the CHC and NAFLD patients.
authors.affiliation: Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Miyaaki
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Naota
authors.initials: N
authors.lastname: Taura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miuma
authors.forename: Takuya
authors.initials: T
authors.lastname: Honda
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Shibata
authors.forename: Kan
authors.initials: K
authors.lastname: Toriyama
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
mesh_terms: D005951:Glucose Tolerance Test; D019698:Hepatitis C, Chronic / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D006946:Hyperinsulinism / Q000209:etiology / Q000503:physiopathology*; D007328:Insulin / Q000378:metabolism*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications / Q000378:metabolism* / Q000503:physiopathology; D012189:Retrospective Studies
chemical_list: D007328:Insulin