Kronik hepatit C virüs (HCV) enfeksiyonunda glukoz intoleransı ve glukoz yüklemeye insülin C-peptid yanıtı
Küçük Resim Yok
Tarih
1999
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Kronik HCV enfeksiyonunda diğer siroz nedenlerinden farklı olarak daha yüksek oranda diabetes mellitus (DM) görülmektedir. Bu çalışmada kronik HCV enfeksiyonlu hastalarda (43 hasta) glukoz metabolizmasındaki değişikliklere ışık tutabilmek için oral glukoz tolerans testi (OGTT) ve bu teste insülin, C-peptid yanıtı incelenmiş, elde edilen değerler kronik B hepatitli hastalar (24 hasta) ve kontrol grubu (11 olgu) ile kıyaslanmıştır. OGTT ile kronik HCV enfeksiyonlu 6 (%14) olguda DM, 4 (%9) olguda glukoz intorensı tesbit edilirken, kronik HBV enfeksiyonlu 4(%16) olguda DM, 1 (%4)olguda glukoz intoleransı saptanmıştır. Kronik HCV'li olgularda 1. saat insülin ve bazal C-peptid düzeyleri kontrol grubundan daha yüksekti (p<0.05). Eğri altında kalan glukoz alanları hem C hepatit hem de C sirozlu hastalarda, insülin alanı ise yalnızca C sirozlu olgularda kontrol grubundan yüksekti (p<0.05). Kronik HCV enfeksiyonunda 1. saat C-peptid/insülin oranı kontrol grubundan belirgin olarak düşüktü (p<0.05). Kronik B hepatit ve B sirozlu hastaların insülin ve bazal C peptid düzeyleri, glukoz ve insülin alanları kontrol grubundan farklı değildi. Sonuç olarak glukoz, insülin alanları, bazal C-peptid düzeylerindeki yükseklik ve 1. saatteki hiperinsülinemi her 3 grup karşılaştırıldığında kronik HCV enfeksiyonunda belirgindir. Kronik HCV enfeksiyonunda C-peptid/insülin oranında 1. saatte düşük değerler elde edilmesi karaciğerde insülin klirensindeki bir bozukluğa bağlı olarak oluşan hiperinsülinemiyi akla getirmektedir. Kronik HCV enfeksiyonunda hiperinsülinemiye karşın glukoz tolerans bozukluğu insülin direncini düşündürmektedir. Olasılıkla da insülin direnci HCV enfeksiyonundaki glukoz intoleransından sorumlu faktörlerden biridir.
It's reported that an increased incidence of diabetes mellitus (DM) in chronic hepatitis C virus (HCV) infection is seen when compared with other chronic liver diseases. We studied oral glucose tolerance test (OGTT) in 43 patients with HCV infection comparing with 24 patients with HBV infection and 11 controls. And then we investigated insulin and C-peptide response to OGTT in these three groups. We determined 6 patients with DM and 4 patients with glucose intolerance in chronic HCV infection and 4 patients with DM and 1 patient with glucose intolerance in chronic HBV infection. Insulin le-vels at 1 hour and basal C-peptide levels were higher in patients with HCV infection than in controls (p<0.05). Glucose areas under curve in patients with chronic HCV infection(hepatitis and cirrhosis) and insulin areas under curve in patients with chronic HCV cirrhosis were higher than in controls(p<0.05). In patients with HBV infection the mean values of glucose levels at OGTT, insulin and C-peptid levels were not different from the levels in controls. We concluded that glucose areas under curve,basal C peptid levels and insulin levels at 1st hour are higher in chronic HCV infection than in other two groups. The lower C-peptide/insulin ratios in HCV infection had indicated hyperinsulinemia because of the decreased hepatic insulin degradation. Glucose intolerance in HCV infection despite the hyperinsulinemia may point to insulin resistance is one of the causative factors of impaired glucose metabolism.
It's reported that an increased incidence of diabetes mellitus (DM) in chronic hepatitis C virus (HCV) infection is seen when compared with other chronic liver diseases. We studied oral glucose tolerance test (OGTT) in 43 patients with HCV infection comparing with 24 patients with HBV infection and 11 controls. And then we investigated insulin and C-peptide response to OGTT in these three groups. We determined 6 patients with DM and 4 patients with glucose intolerance in chronic HCV infection and 4 patients with DM and 1 patient with glucose intolerance in chronic HBV infection. Insulin le-vels at 1 hour and basal C-peptide levels were higher in patients with HCV infection than in controls (p<0.05). Glucose areas under curve in patients with chronic HCV infection(hepatitis and cirrhosis) and insulin areas under curve in patients with chronic HCV cirrhosis were higher than in controls(p<0.05). In patients with HBV infection the mean values of glucose levels at OGTT, insulin and C-peptid levels were not different from the levels in controls. We concluded that glucose areas under curve,basal C peptid levels and insulin levels at 1st hour are higher in chronic HCV infection than in other two groups. The lower C-peptide/insulin ratios in HCV infection had indicated hyperinsulinemia because of the decreased hepatic insulin degradation. Glucose intolerance in HCV infection despite the hyperinsulinemia may point to insulin resistance is one of the causative factors of impaired glucose metabolism.
Açıklama
Anahtar Kelimeler
Gastroenteroloji ve Hepatoloji
Kaynak
Türkiye Klinikleri Gastroenterohepatoloji Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
10
Sayı
3
