The role of systemic inflammation in the pathogenesis of insulin resistance and metabolic syndrome in patients with chronic hepatitis C

• Published in: Terapevtic̆eskii arhiv Vol. 90; no. 11; pp. 24 - 31
• Main Authors: Tkachenko, L I, Maleev, V V
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) 01.01.2018
• Subjects: Adiponectin; Adolescent; Adult; Aged; Hepatitis C, Chronic - complications; Humans; Inflammation; Insulin Resistance; Leptin; Metabolic Syndrome - complications; Middle Aged; Random Allocation; Young Adult; metabolic syndrome; ferritin; C-reactive protein; insulin resistance; chronic hepatitis C
• ISSN: 0040-3660
• DOI: 10.26442/terarkh2018901124-31

To determine the role of nonspecific inflammation in the formation of IR and metabolic syndrome in patients with chronic hepatitis C. The study included 205 patients with CHC aged 18 to 69 years. Patients with CHC are randomized into two groups depending on the presence of IR: group 1 - patients with a HOMA index ≥2.77, which corresponded to IR (n=110); group 2 (n=95). The levels of serum iron, C-reactive protein (CRP), serum ferritin and adipose tissue hormones [leptin, resistin, adiponectin and tumor necrosis factor-α (TNF-α)] were additionally investigated. At all stages of development of IR, nonspecific inflammation was detected (according to ferritin, CRP and serum iron), increasing with increasing HOMA index [Homeostasis Model of Assessment - Insulin Resistance (HOMA-IR)] (Matthews D., 1985), metabolic syndrome and its components. In the analysis of indicators in patients with chronic hepatitis C with a body mass index <25 kg/m2, conjugacy of IR with low-intensity inflammation, high viral load and hypersecretion of TNF-α was detected. Given the high predictor role of CRP indicators in predicting IR, it should be used as a surrogate screening marker of IR in patients with chronic hepatitis C and should be actively treated for violations.