Analysis Of Insulin Resistance Related Factors In Patients With Chronic Hepatitis C

Background To evaluated the relations between serum TNF-a, retionol-binding protein-4(RBP-4) and the adiponectin(ADPN) of 69 HCV-infected subjects to explore the relationship between these factors and homeostasis model assessment of insulin resistance (HOMA-IR), which will provide a basis theory for study on the mechanism of insulin resistance in patients with chronic hepatitis C. Then elucidated the effects of peg-ifn a-2a plus ribavirin on the serum levels of TNF-α,ADPN,RBP-4 and insulin resistance.Methods The serum levels of TNF-a, RBP 4, ADP, fast glucose (FPG), fast insulin (Fins) and triglyceride(TG), total cholesterol(TC), alanine aminotransferase(ALT), gamma-glutamy transpeptidase(GGT), HCV-RNA levels of 69 patients with CHC and 50 normal subjects were measured.insulin resistance index (HOMA-IR),BMI of them were separately computed. Then We analyzed 12 patients with HCV infection who received combination treatment of 180 microg of pegylated interferon alpha-2a plus ribavirin Continued to six months and observed the change of each factor and insulin resistance.Results The patients with chronic hepatitis c have higher fasting plasma glucose, fasting insulin and insulin resistance index (t=3.75,t=3.43,t=3.68,P<0.05). The serum TNF-a,RBP4 level are higher in HCV patients while ADPN level is lower than the normal group (t=14.3,t=5.86,t=-4.76,P<0.05).Multivariate regression analysis showed that insulin resistance index of patients with chronic hepatitis c has a linear dependence relation with RBP and ADPN(P<0.05). twelve patients achieved the virologic response after 6 mouth therapy by peg-ifn a-2a plus ribavirin.before and after treatment, the fasting plasma glucose level,Fasting serum insulin level and HOMA-IR were not significantly difference. But The levels of ADPN was reduced after antiviral treatment.Conclusion RBP and ADPN are independent factors of insulin resistance in chronic hepatitis c patients. They play important parts in the process of insulin resistance. The patients who achieved the virologic response after 6 mouth therapy by peg-ifn a-2a plus ribavirin can not improves insulin resistance,But can lower the lelve of ADPN.