[Insulin resistance and chronic hepatitis C].

Area of Science:

• Hepatology
• Endocrinology
• Metabolic Diseases

Background:

• Insulin resistance (IR) is a growing concern in chronic hepatitis C (CHC) patients.
• The interplay between IR, hepatic steatosis (HS), and liver fibrosis (LF) progression in CHC requires further elucidation.
• Understanding the impact of IR on antiviral therapy (AVT) outcomes is critical for patient management.

Purpose of the Study:

• To estimate the prevalence of IR in CHC patients.
• To define the role of IR in the development of HS and progression of LF.
• To assess the impact of IR on AVT outcomes in CHC.

Main Methods:

• A study involving 211 CHC patients and 75 chronic hepatitis B (CHB) patients.
• Patients were categorized based on the presence of IR and type 2 diabetes mellitus (DM).
• IR was specifically analyzed in CHC patients with a body mass index (BMI) <25 kg/m2 and early LF.

Main Results:

• IR and type 2 DM were significantly more prevalent in CHC patients compared to CHB patients.
• IR, particularly with DM, was associated with higher liver disease activity, inflammation, and advanced LF.
• IR correlated with metabolic syndrome, HS, vitamin D deficiency, and poorer response to AVT, especially in patients with BMI <25 kg/m2 and early LF.

Conclusions:

• IR is common in CHC patients, even with normal BMI and early LF.
• IR is significantly associated with HS and advanced LF in CHC.
• Routine screening for IR in all CHC patients is recommended for timely intervention and improved therapeutic results.