Gökhan DİNDAR, Sadettin HÜLAGU, Ali Erkan DUMAN, Uğur KORKMAZ, Murat ÖZTÜRKLER, Hasan YILMAZ, Bülent YILMAZ, Altay ÇELEBİ, Ömer ŞENTÜRK

KRONİK HEPATİT B HASTALARINDA İNSULİN DİRENCİ SIKLIĞI

Amaç: Bu çalışmada kronik hepatit B hepatiti tanısı olan hastalarda insülin rezistansı sıklığı ile karaciğer biyopsisinde saptanan fibrozis üzerine etkisini değerlendirmek amaçlanmıştır. Metod: 2010-2012 yılları arasında kronik viral hepatit B tanısı ile takip edilen ve karaciğer biyopsisiyapılan 52 hasta değerlendirildi. Tüm hastalarda tam kan sayımı, glukoz ve biyokimya tetkikleri,hepatit belirteçleri, Hepatit B Virüs DNA düzeyleri çalışıldı. Vücut kitle indeksi (kg/m2) ve insülin direnci (HOMA-IR) = [açlık insülin (µU/mL) X AKŞ (mmol/L)] / 22.5 olarak hesaplandı. Karaciğer histo- lopatolojisi histolojik aktivite indeksi ve fibrozis yönünden Ishak sınıflamasına göre değerlendirildi. Bulgular: Çalışmadaki 52 hastanın 34inde (%65) insulin direnci mevcuttu. İnsulin direnci olan kronik HBV hastaları ile insulin direnci olmayan Hepatit B Virüs (HBV) hastaları arasında yaş, AlaninAminotransferaz (ALT), Aspartat Aminotransferaz (AST), fibrozis ve histolojik aktivite indeksi açısından anlamlı fark saptanmadı. Bununla birlikte insulin direnci olan kronik HBV hastalarının insulindirenci olmayan Hepatit B Virüs (HBV) hastalarına göre istatistiksel olarak anlamlı olarak yüksekVücut Kitle İndeksi (BMİ) ve düşük Hepatit B Virüs DNA değerlerine sahip oldukları görüldü. Sonuç: İnsulin direnci kronik hepatit B hastalarında sıklıkla saptanmaktadır. Kronik hepatit B hastalarında insulin direnci araştırılmalı ve bu hastalara diabetes mellutis hakkında bilgi verilmelidir.

Frequency of Insulin Resistance in Chronic Hepatitis B Patients

Objective: This study was performed to determine the frequency of insulin rezistance amongpatients with chronic hepatitis B and to demonstrate the association with biopsy proven liverfibrosis. Methods: A group of 52 patients who had undergone liver biopsy for chronic hepatitis B between2010 and 2012 were evaluated. In all cases, complete blood count, serum fasting glucose, andbasic biochemical tests, hepatitis markers, hepatitis B virus DNA levels were performed. The bodymass index was calculated as kg/m2 and the insulin resistance was calculated as (HOMA-IR) =[fasting insulin (µU/mL) X fasting blood glucose (mmol/L)] / 22.5. Results: Of 52 patients who chronic hepatitis B infection, 34 had insulin resistance. When the chronic hepatitis B patients with and without insulin resistance were compared, there was nosignificant difference between the groups in terms of age, ALT, AST, fibrosis and Histologic ActivityIndex. However, chronic hepatitis B patients with insulin resistance had significantly higher levelsof BMI and lower levels of HBV DNA. Conclusion: Insulin resistance is firuquently seen among the patients with chronic hepatitis B. Theinsulin resistance must be investigated in chronic hepatitis b patients and they must be informedabout diabetes mellitus.

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