The role of systemic inflammation in the pathogenesis of insulin resistance and metabolic syndrome in patients with chronic hepatitis C


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Abstract

The systemic inflammatory response plays a key role in the development of atherosclerosis, insulin resistance (IR) and diabetes mellitus 2-type (diabetes mellitus). IR in patients with chronic hepatitis C (CHC) is considered as a possible factor in the progression of fibrosis, a predictor of the development of DM T2 and a component of the metabolic syndrome. The use of biomarkers of non-specific inflammation can be a valuable tool for assessing the risks of IR and cardiovascular diseases in patients with chronic hepatitis C. Aim of the study. To determine the role of nonspecific inflammation in the formation of IR and metabolic syndrome in patients with chronic hepatitis C. Materials and methods. The study included 205 patients with CHC aged 18 to 69 years. Patients with CHC are randomized into two groups depending on the presence of IR: group 1 - patients with a HOMA index ≥2.77, which corresponded to IR (n=110); group 2 (n=95). The levels of serum iron, C-reactive protein (CRP), serum ferritin and adipose tissue hormones [leptin, resistin, adiponectin and tumor necrosis factor-α (TNF-α)] were additionally investigated. Results. At all stages of development of IR, nonspecific inflammation was detected (according to ferritin, CRP and serum iron), increasing with increasing HOMA index [Homeostasis Model of Assessment - Insulin Resistance (HOMA-IR)] (Matthews D., 1985), metabolic syndrome and its components. In the analysis of indicators in patients with chronic hepatitis C with a body mass index <25 kg/m2, conjugacy of IR with low-intensity inflammation, high viral load and hypersecretion of TNF-α was detected. Conclusion. Given the high predictor role of CRP indicators in predicting IR, it should be used as a surrogate screening marker of IR in patients with chronic hepatitis C and should be actively treated for violations.

About the authors

L I Tkachenko

Stavropol State Medical University of the Ministry of Health of the Russian Federation

Email: larisa308@mail.ru
д.м.н., проф. каф. инфекционных болезней с курсом фтизиатрии и ДПО ФГБОУ ВО СтГМУ Минздрава России Stavropol, Russia

V V Maleev

Central Research Institute of Epidemiology of the Federal Service on Customers' Rights Protection and Human Well-being Surveillance

акад. РАН, д.м.н., проф., советник директора по научной работе ФБУН «ЦНИИ эпидемиологии» Роспотребнадзора Moscow, Russia

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