Study of selenoprotein p as a possible marker of insulin resistance in type 2 diabetes and chronic hepatitis C

Abstract

Diabetes mellitus is one of the most common endocrine disorders affecting almost 6% of world population. The prevalence of this chronic metabolic disease is increasing. Globally, the number of people with diabetes is expected to rise from the current estimate of 150 million to 220 million in 2010 and 300 million in 2025. Egypt is expected to be among ten countries with the highest number of estimated cases of diabetes for 2030. The prevalence of type 2 DM continues to rise at alarming rate. Significant defect in glucose homeostasis and fuel metabolism are detectable long before overt diabetes occurs. One of the earliest derangements in metabolism is insulin resistance. The liver plays important roles in the homeostasis of glucose metabolism since it acts as a major target organ for insulin and a site for gluconeogenesis and glycogen storage. Diabetes mellitus commonly develops in patients with chronic hepatitis C virus. Up to one third of patients with chronic hepatitis C virus (HCV) develop type 2 diabetes mellitus (DM). This prevalence is much higher than that observed in the general population, and in patients with other chronic liver diseases such as hepatitis B virus, ¨ Summary and Conclusions 119 alcoholic liver disease, and primary biliary cirrhosis. As the result of hepatocyte dysfunction, is known as hepatogenous diabetes mellitus. Selenoprotein P (SeP), a liver-derived secretory protein, causes insulin resistance. Hepatic SeP mRNA levels correlated with insulin resistance in humans. Administration of purified SeP impaired insulin signaling and dysregulate glucose metabolism in both hepatocytes and myocytes these results demonstrate a role of SeP in the regulation of glucose metabolism and insulin sensitivity). Recently attention has been paid to the role of Selenoprotein P (SeP) in the pathogenesis of insulin resistance. The aim of this study is to assess the relationship between insulin resistance and selenoprotein p in type 2 diabetes mellitus and chronic hepatitis C. The study was conducted on 55 of adult person's age range from 30-60 years; they were divided into 3 groups: Group 1: 20 diabetic patients. Group 2: 20 HCV patients (Child A). Group 3: 15 control subjects. ¨ Summary and Conclusions 120 The data were statistically analysed and it is found that: · SeP was highest among group 2 (HCV) (10.8±2.47) mg/dl compared to group 1 (Diabetes) (8.9±3.01) mg/dl and group 3 (Controls) (7.8±2.7) mg/dl · Fasting plasma glucose was high in group 1 (Diabetes) (194.1±50.63) mg/dl and normal in group 2 (HCV) (86.4±8.75) compared with group 3 (Controls) (91.9±6.38). · As regards HbA1C% it was high in group 1 (Diabetes) (7.4±0.45) and normal in group 2 (HCV) (5.3±0.31) compared with group 3 (Controls) (5.6±0.79). · Concerning BMI, it was <25 kg/m2 in all groups · The mean BMI of group 1(Diabetes) (23.47±1.53), group 2(HCV) (22.7±2.02), group 3(Controls) (23.6±1.28). · ALT and AST were found to be (21+3.83) u/l and (24±3.83) u/l respectively in group 1 (Diabetes), (25.9 ± 12.64) u/l and (26.9 +9.88) u/l respectively in group 2 (HCV) u/l, and in group 3 (Controls) (20±3.09) u/l and (25±3.02) u/l respectively.