Brief Article
Copyright ©2010 Baishideng. All rights reserved
World J Gastroenterol. May 14, 2010; 16(18): 2265-2271
Published online May 14, 2010. doi: 10.3748/wjg.v16.i18.2265
Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection
Chao-Hung Hung, Jing-Houng Wang, Tsung-Hui Hu, Chien-Hung Chen, Kuo-Chin Chang, Yi-Hao Yen, Yuan-Hung Kuo, Ming-Chao Tsai, Sheng-Nan Lu, Chuan-Mo Lee
Chao-Hung Hung, Jing-Houng Wang, Tsung-Hui Hu, Chien-Hung Chen, Kuo-Chin Chang, Yi-Hao Yen, Yuan-Hung Kuo, Ming-Chao Tsai, Sheng-Nan Lu, Chuan-Mo Lee, Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Niao Sung 833, Kaohsiung, Taiwan, China
Author contributions: Hung CH designed and performed the research and wrote the paper; Hung CH, Wang JH, Hu TH, Chen CH, Chang KC and Yen YH contributed to acquisition of data; Kuo YH and Tsai MC performed historical analysis; Lu SN performed statistical analysis; Lee CM performed critical revision.
Supported by National Science Council (Republic of China, Taiwan), Grant No. NSC96-2314-B182A-088
Correspondence to: Dr. Chao-Hung Hung, Division of Hepatogastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, 123 Ta Pei Road, Niao Sung 833, Kaohsiung, Taiwan, China. chh4366@yahoo.com.tw
Telephone: +886-7-7317123 Fax: +886-7-7322402
Received: January 22, 2010
Revised: March 1, 2010
Accepted: March 8, 2010
Published online: May 14, 2010
Abstract

AIM: To elucidate the role of insulin resistance (IR) and serum adiponectin level in hepatocellular carcinoma (HCC) associated with chronic hepatitis C.

METHODS: Clinical and biochemical characteristics were collected from 165 consecutive patients with newly diagnosed HCC. Homeostasis model assessment of IR (HOMA-IR) and serum adiponectin level were investigated in 188 patients with different stages of hepatitis C virus (HCV) infection.

RESULTS: Among HCC patients, type 2 diabetics (DM) was more prevalent in HCV subjects (35.6%, n = 59) compared to hepatitis B virus (HBV; 12.7%, n = 63) or non-HBV, non-HCV cases (7.1%, n = 28). In patients with chronic hepatitis C, HCC subjects had higher blood sugar (P < 0.001), insulin level (P = 0.003) and HOMA-IR (P = 0.018) than those with chronic hepatitis and advanced fibrosis. Age, male sex and body mass index were significantly associated with serum adiponectin level, whereas HOMA-IR was not. Based on stepwise logistic regression analysis, age (OR: 1.124, P < 0.001), serum insulin level (OR: 1.585, P < 0.001), HOMA-IR (OR: 0.495, P = 0.001), DM (OR: 11.601, P = 0.002) and male sex (OR: 3.877, P = 0.016) were independently associated with HCC. This result was similar even if the diabetic subjects were excluded for analysis.

CONCLUSION: Insulin resistance measured by HOMA-IR, regardless of the presence of diabetes, is significantly associated with HCC development in patients with chronic HCV infection.

Keywords: Hepatitis C virus; Hepatocellular carcinoma; Insulin resistance; Diabetes; Adiponectin