Plasma homocysteine and its relationship to insulin status in patients with hepatitis C virus related chronic liver diseases

الملخص EN

Background : Hepatitis C virus is one of the major health problems in Egypt.

It affects mainly the liver but several extrahepatic manifestations were also reported.

Insulin resistance (IR) in hepatocytes is expected to have important systemic consequences.

It also promotes the disease progression in chronic viral hepatitis C.

Hyperhomocysteinemia (HHcy) may promote IR through different mechanisms.

Aim : This study aimed to evaluate homocysteine (Hcy) plasma levels in patients with HCV related chronic liver disease and to determine its relationship to insulin status.

Methods : Forty-five subjects were included in the present study : fifteen healthy volunteers constituted the control group (Group I), and thirty nondiabetic HCV patients were selected[15 non cirrhotic (group II), and 15 cirrhotic patients (group III)].

All patients and controls were subjected to clinical examination, abdominal ultrasonography, some laboratory investigations, determination of fasting plasma glucose, insulin and homocysteine and calculation of HOMA-IR score.

Results : Significant increase was found in total-Hcy, insulin and HOMA-IR score in cirrhotic group (group III) as compared to the other two groups.

A significant positive correlation was found between homocysteine and both of insulin and HOMA-IR score in the cirrhotic group (r = 0.91, p < 0.001, r = 0.94, p < 0.001) respectively.

Conclusion : The presence of both hyperhomocysteinemia and insulin resistance and their association in cirrhotic HCV patients may create a deleterious feedback loop each promoting the development of the other.

Treatment of HHcy and IR might be promising to slow down the progression of hepatitis C to cirrhosis.