Tumor Necrosis Factor-a and Iron Overload Are Associated with Insulin Resistance in Hepatitis C in Egyptian Patients

Abstract

Background: There are evidences of an increased incidence of insulin resistance (IR) in patients with hepatitis C virus infection. Several mechanisms have been proposed to explain the increased IR in hepatitis C. Aims: To evaluate tumor necrosis factor-alpha (TNF- and iron overload as potential mediators of IR development in chronic HCV patients. Patients and Methods: Study groups consisted of four groups: patients with HCV infection (n = 35), patients with hepatitis C and diabetes mellitus (HCV+DM) (n = 31), patients with DM (n = 36), and healthy controls (n = 30). The homeostatic model assessment (HOMA) was the criteria used to quantify the degree of IR. Results: HOMA indices were significantly higher in the HCV, HCV+DM and DM groups compared to the healthy controls (P < 0.001 for each). TNF-α was significantly higher in HCV and HCV+DM groups compared with DM and healthy controls (P < 0.001 for each). TNF- was significantly higher in HCV+DM group compared with HCV group (P < 0.05). Furthermore, TNF-α was positively correlated with HOMA indices in HCV and HCV+DM groups (r= ~ +0.900, P < 0.001). Serum ferritin had a positive correlation with HOMA indices in HCV and HCV+DM groups (r= ~ +0.800, P < 0.001). Conclusion: TNF- and iron overload may explain in part the development of IR in chronic HCV patients.