Hepcidin and Insulin Profiles in Obese and Non Obese Chronic HCV Non Cirrhotic patients with Type 2 Diabetes Mellitus

Mahy Yasser Emara


Abstract


Hepatitis C virus infection is one of the main causes of chronic liver disease worldwide CHC patients frequently develop mild to moderate iron overload. Many experimental and clinical studies suggest that excessive iron in CHC is a cofactor promoting the progression of liver damage and increasing the risk of fibrosis, cirrhosis. Hepatic iron overload produces oxidative stress and is a factor responsible for the development of HCV-associated IR With the recent discovery of hepcidin, the liver has emerged as the central organ in the regulation of systemic iron homeostasis; Very recent studies have suggested that HCV infection may directly modulate hepcidin expression The current study aimed at evaluating the effect of hepcidin on insulin profile in patients with chronic HCV and type 2 diabetes mellitus regardless they are obese or not. The present study is a case control study that included 50 patients, 40 patients who are chronic HCV positive patients with type DM which are further subdivided into 2 groups , Group DVO which includes 20 patients who are obese (BMI more than 30 kg/m2) with HCV and type 2 Diabetes mellitus and Group (DVN) which includes 20 patients who are non-obese (BMI less than 30 kg/m2) with HCV and type 2 Diabetes mellitus and 10 healthy volunteers who served as controls that were age, and socioeconomic status matched with the patients. Patients who were Hepatitis C virus negative, or were HBV positive, or having Type 1 Diabetes Mellitus, acute viral hepatitis, liver cirrhosis and chronic renal failure were excluded from this study. A fasting blood sample was withdrawn from each group and tested for Serum Hepcidin, Serum Ferritin, Transferrin saturation, Insulin level, Blood glucose level and C-Peptide level. The blood glucose level and serum insulin level are used to quantify insulin resistance using HOMA-IR equation. The current study noted serum hepcidin level was significantly lower in CHC patients than in controls and serum iron, serum ferritin and transferrin saturation were significantly higher in CHC patients than in non HCV control group Upon correlation different variables and factors with insulin levels and HOMA-IR to evaluate the effect of hepcidin levels on insulin patterns in obese and non-obese type 2 diabetic patients, this study confirmed a positive correlation between body mass index, insulin levels, blood glucose levels and C-peptide level with HOMA-IR, on the contrary there was no positive correlation between serum ferritin and serum hepcidin with HOMA-IR We believe that limitations in this study are that the study should have been performed on a wider sample of patients, presence of multiple factors that can affect HOMA-IR such as diabetes mellitus and obesity and lastly absence of liver biopsy to determine the concentration of hepatic iron which correlates with the severity of hepatic insulin resistance. In Conclusion, we have found reduced serum hepcidin levels in chronic hepatitis c patients but we need further investigations and researches to evaluate the direct effect of the hormone suppression on insulin levels and HOMA-IR.


Other data

Other Titles معدل الهبسيدين و الانسولين في مرضى التهاب الكبد الوبائي المزمن ج و مرض السكري من النوع الثاني بدون وجود تليف كبدي سواء كانوا يعانون من السمنة المفرطة أو لا
Issue Date 2016
URI http://research.asu.edu.eg/handle/12345678/54202


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