Resistin Hormone A Possible Marker of Insulin resistance in chronic HCV and Type 2 Diabetic patients

Background: Insulin resistance is a state in which a given concentration of insulin produces a less than expected biological effect. Chronic (HCV) infection triggers a multistep vicious cycle of insulin resistance (IR) and hyperinsulinaemia that gradually progress to frank type 2 diabetes mellitus (DM). HCV induces several complex mechanisms that lead to inflammation, insulin resistance, steatosis, fibrosis, apoptosis, altered gene expression, and hepatocellular carcinoma (HCC). Up to one third of patients with chronic (HCV) develop type 2 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, alcoholic liver disease and primary liver cirrhosis. Resistin, an adipose-derived polypeptide hormone, offers a novel application potential as a clinical biomarker in the assessment of liver cirrhosis. Elevated resistin may contribute to insulin resistance in advanced liver dysfunction. Objective: To assess the level of resistin hormone in patients with chronic HCV and in Type 2 diabetic patients and its possible relation to insulin resistance and severity of liver disease in HCV patients. Study design: This study was conducted on sixty patients recruited from the Hepatology Clinic and Internal Medicine out-patients clinic of Ain Shams University Hospitals. Patients were divided into 4 groups, Group (1): This group included 15 patients with type 2 DM and compensated chronic HCV infection (child A), Group (2) This group included 15 patients with type 2 DM and decompensated chronic HCV infection (child C), Group (3) This group included 15 patients with type 2 DM and normal liver function tests (clinical, biochemical and by ultra sound). Group (4) this group included 15 normal subjects as a control group without any metabolic or liver diseases. Results: serum Resistin was significantly higher among group (2) Diabetic patients with decompensated liver disease (19.20±3.19 ng/ml) than group (1) (15.68±3.42 ng/ml) group (3) (15.29±3.04) and group (4) (5.09±2.00) (P<0.01). Group 2 had significant higher FBG, Fasting insulin, HOMA-IR, AST, ALT, PT, Bilirubin and significant lower serum albumin when compared to other groups.Correlation studies showed a significant direct correlation between Resistin and FBG (r = 0.780), fasting insulin(r = 0.839) and HOMA-IR (r = 0.685) in group 1,and a significant direct correlation between resistin and FBG (r = 0.847), and HOMA-IR (r = 0.812) in group 2, in group 3 there was a significant direct correlation between resistin and fasting insulin (r = 0.937), HOMA-IR (r = 0.784) and a direct significant correlation between resistin and Fasting insulin (r = 0.910), HOMA-IR (r = 0.905) and a significant indirect correlation between Resistin and serum albumin (r = 0.519) in group 4.Conclusion: Resistin is increased in IR cases like type 2 DM and HCV patients and is related to the severity of liver disease. [Abdelsattar E Eldib, Khaled M Makboul, Maram M Mahdy, Doaa Z Zaky, Mervat E Seddik. Resistin Hormone A Possible Marker of Insulin resistance in chronic HCV and Type 2 Diabetic patients. Life Sci J 2014;11(12):7884]. (ISSN:1097-8135). http://www.lifesciencesite. com. 14