Relationship Between Muscle Mass and Insulin Resistance in Cirrhotic Patients with Hepatitis B

Objective: Hepatitis B virus (HBV) affects over 400 million people in the world and is a major threat despite all measures taken for its prevention. It is one of the most important causes of liver cirrhosis. Liver cirrhosis causes malnutrition as a result of decreased oral intake, both because of the disease itself and multiple other reasons. Studies showed an inverse correlation between muscle mass and insulin resistance. We aimed to evaluate the relationship between insulin resistance, muscle mass, and muscle strength in patients with HBV-related cirrhosis. Methods: We included 65 patients with HBV-related cirrhosis in Child-Pugh class A and B groups and 65 healthy control individuals in this monocentric study. Muscle mass indices were calculated with bioimpedance analysis for both groups to determine muscle strength and muscle mass. Handgrip strength, arm, and calf circumferences were measured. In both groups, HOMA-IR values were calculated to determine insulin resistance. Correlations of fasting glucose, fasting insulin, HbA1C, LDL, HDL, triglyceride, and cholesterol levels with calf and waist circumference measurements were detected. The relationship between muscle mass and insulin resistance, laboratory results, and waist and calf circumference was evaluated. Results: The mean value of muscle mass index was 10.98±11.40 kg/m2 in cirrhotic patients and 9.88±1.12 kg/m2 in healthy control individuals. HOMA-IR values were detected as 3.47±3.80 in the study group and 1.83±1.20 in the control group. The correlation coefficient between muscle mass and insulin resistance was statistically insignificant, especially in the study group. Conclusion: In our study, there was no relationship between muscle mass and insulin resistance in cirrhotic patients with hepatitis B.

Hepatit B’ye Bağlı Sirotik Hastalarda Kas Kitlesi ile İnsülin Direnci Arasındaki İlişki

Amaç: Hepatit B virüsü, tüm önlemlere rağmen, dünyada 400 milyon üzerinde kişiyi etkilemekte ve büyük tehdit oluşturmaktadır. Karaciğer sirozunun en önemli nedenlerinden birisidir. Karaciğer sirozu ise hastalığın hem kendinden kaynaklanan, hem de çeşitli nedenlerle oral alımda azalma sonucu malnutrisyona neden olmaktadır. Yapılan çalışmalarda kas kitlesi ile insülin direnci arasında ki ters korelasyon belirlenmiştir. Biz hepatit B nedeniyle siroz gelişen hastalarda insülin direnci ile kas kitlesi ve kas gücü arasında ki ilişkiyi değerlendirmeyi amaçladık. Gereç ve Yöntem: Tek merkezli olarak yönetilen bu çalışmaya 65 hepatit B’ye bağlı Child A ve Child B grubundaki sirotik hastalar ile 65 kontrol hastası dahil edilmiştir. Her iki grupta kas gücünü ve kitlesini belirlemek amacı ile bioempedans analiz ile kas kitle indeksi (kas kitlesi /boy², kg/m²) hesaplandı. El sıkma gücü, kol ve baldır çevresi bakıldı. Her iki grupta insülin direncinin belirlenmesi amacı ile HOMA-IR [(açlık insülinμU/mL)X (AKŞmmol/L)/22.5] bakıldı. Her iki gruptan açlık insülin, açlık glukoz, HbA1c, LDL, HDL, trigliserit, kolesterol düzeyleri, baldır çevresi ile bel çevresi bakıldı. Kas kitlesi ile insülin direnci, laboratuvar değerleri, bel çevresi ve baldır çevresi arasındaki ilişki değerlendirildi. Bulgular: Çalışmamızda, hasta grubunun kas kitle indeksi ortalaması 10.98±11.40, kontrol grubunun kas kitle ortalaması 9.88±1.12 olarak belirlendi. HOMA-IR değeri ise hasta katılımcılarda 3.47±3.80, kontrol grubunda ise 1.83±1.20 olarak belirlendi. Özellikle hasta grubunda bakılan kas kitlesi ile insülin direnci arasında hesaplanan korelasyon katsayısı istatistiksel olarak anlamlı bulunmamıştır. Sonuç: Çalışmamızda hepatit B’ye bağlı sirotik hastalarda kas kitlesi ile insülin direnci arasında ilişki bulunmamıştır.

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Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

658118

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