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. 2010 May 14;16(18):2265-71.
doi: 10.3748/wjg.v16.i18.2265.

Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection

Chao-Hung Hung  1 , Jing-Houng Wang, Tsung-Hui Hu, Chien-Hung Chen, Kuo-Chin Chang, Yi-Hao Yen, Yuan-Hung Kuo, Ming-Chao Tsai, Sheng-Nan Lu, Chuan-Mo Lee
Affiliations

Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection

Chao-Hung Hung et al. World J Gastroenterol. .

Abstract

Aim: To elucidate the role of insulin resistance (IR) and serum adiponectin level in hepatocellular carcinoma (HCC) associated with chronic hepatitis C.

Methods: Clinical and biochemical characteristics were collected from 165 consecutive patients with newly diagnosed HCC. Homeostasis model assessment of IR (HOMA-IR) and serum adiponectin level were investigated in 188 patients with different stages of hepatitis C virus (HCV) infection.

Results: Among HCC patients, type 2 diabetics (DM) was more prevalent in HCV subjects (35.6%, n = 59) compared to hepatitis B virus (HBV; 12.7%, n = 63) or non-HBV, non-HCV cases (7.1%, n = 28). In patients with chronic hepatitis C, HCC subjects had higher blood sugar (P < 0.001), insulin level (P = 0.003) and HOMA-IR (P = 0.018) than those with chronic hepatitis and advanced fibrosis. Age, male sex and body mass index were significantly associated with serum adiponectin level, whereas HOMA-IR was not. Based on stepwise logistic regression analysis, age (OR: 1.124, P < 0.001), serum insulin level (OR: 1.585, P < 0.001), HOMA-IR (OR: 0.495, P = 0.001), DM (OR: 11.601, P = 0.002) and male sex (OR: 3.877, P = 0.016) were independently associated with HCC. This result was similar even if the diabetic subjects were excluded for analysis.

Conclusion: Insulin resistance measured by HOMA-IR, regardless of the presence of diabetes, is significantly associated with HCC development in patients with chronic HCV infection.

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Figures

Figure 1
Figure 1
Comparison of high homeostasis model assessment of insulin resistance (HOMA-IR) (> 4) among different stages of chronic hepatitis C virus (HCV) infection (P = 0.036).
See this image and copyright information in PMC

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