STUDY OF FASTING SERUM INSULIN, INSULIN AUTO ANTI BODIES, ISLET CELL ANTIBODIES AND GLUCOSE TOLERANCE IN PATIENTS WITH CHRONIC HEPATITIS C VIRUS INFECTION
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The aim of this study is to investigate fasting serum insulin (FSI), insulin auto- - antibodies (IAA), islet cell antibodies (ICA) and glucose tolerance in patients with chronic hepatitis C virus (CHCV) infection to find a possible link between CHCV infection and diabetes mellitus (DM). Ninety-three cases with CHCV infection were selected as a study group from those admitted at the internai medicine department of Bertha University Hospitals (59 were males and 34 were females). Their ages ranged from 40 to 60 years old (with a mean age of 53.3±6.4). Diagnosis of CHCV infection was based on the presence of positive HCV antibodies by 3rd generation ELISA (enzyme linked immunosorbant assay), abnormal elevation of serum transaminases for greater than 6 months, confirmed by positive HCV antigen by polymerase chain reaction (PCR) and liver biopsy which shows the stigmata of chronic hepatitis. Forty healthy subjects were selected as a control group and matched with the study group regarding age, sex, residence, social standard and body mass index. The levels of fasting blood glucose (FBG), two hours post- challenge blood glucose (2-HPBG), IAA and ICA in the study group are significantly higher than in the control group (P< 0.001), while the mean levels of fasting serum insulin (Iand C-peptide are significantly lower in the study group than in the conic group (P< 0.001). Regarding the comparison between the quantity of PCR >0.2 unEq/m1 and <0.2 mEq/m1 and the presence or absence of liver cirrhosis among the studied cases with CHCV infection, there are no statistical significant changes in the mean levels of the previous parameters respectively (P> 0.05). After glucose tolerance test, 38.7% of cases in the study group showed impaired glucose tolerance (IGT) and also, 12.9% of cases in the study group were newly discovered as having DM. However, about 41.6% of cases that were newly discovered as having DM, responded to insulin therapy. It is concluded from this study that, there is an association between CHCV infection and changes in the mean levels of FSI, IAA, ICA, IGT and the presence of DM. We recommend a further study of molecular genetic susceptibility and HCV genotyping in relation to IAA and ICA together with assessment of the exocrine pancreatic and -cell functions in patients CHCV infection to prove or exclude the possible concomitant viral C pancreatitis which may be based on auto-immune phenomena.