Role of Inflammatory Cytokines in Insulin Resistance Among Chronic Hepatitis C Patients

Nouman Mohammed Elgarem; Mohammad Ahmad Elghobary; Rasha Hamed El Sherif; Maha Assem Hussien; Yousra Hamed Mourad

doi:doi:10.11648/j.ajim.20160405.11

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Role of Inflammatory Cytokines in Insulin Resistance Among Chronic Hepatitis C Patients

Nouman Mohammed Elgarem, Mohammad Ahmad Elghobary, Rasha Hamed El Sherif, Maha Assem Hussien, Yousra Hamed Mourad

Published in American Journal of Internal Medicine (Volume 4, Issue 5)

Received: 18 July 2016 Accepted: 2 August 2016 Published: 31 August 2016

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Abstract

Insulin resistance plays an essential role in the pathogenesis of diabetes associated with HCV. High levels of inflammatory cytokines have been found in HCV-infected patients. The aim of the study was to investigate the association of HCV infection with impaired glucose metabolism and to highlight the role of inflammatory cytokines as an initial mechanism involved in insulin resistance development in HCV infection. It included 3 groups of patients: Group I: 50 HCV patients with DM. Group II: 50 HCV patients without DM and Group III: 25 patients with DM alone as control subjects. Insulin resistance was evaluated using the (HOMA - IR) index. We measured the levels of fasting insulin, CRP and two of the inflammatory cytokines of the innate immunity (TNF-α and IL-6 by ELISA). It was found that insulin resistance, CRP and IL6 in group (I) were significantly higher when compared to group (II) and (III) with P-value < 0.001. CRP in group (II) was significantly higher when compared to group (III) with P-value < 0.05. Serum level of (TNF-α) in group (I) was significantly higher when compared to group (II) with P-value < 0.05 and group (III) with P-value < 0.001 as well as in group (II) it was significantly higher when compared to group (III) with P-value < 0.001. CRP, IL-6 and TNF-α had statistically significant positive direct correlation to insulin resistance. In conclusion there was a strong relationship between inflammatory cytokines and the occurrence of insulin resistance in chronic HCV patients with type 2 diabetes mellitus.

Published in	American Journal of Internal Medicine (Volume 4, Issue 5)
DOI	10.11648/j.ajim.20160405.11
Page(s)	79-84
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2016. Published by Science Publishing Group

Keywords

Diabetes, Inflammatory Cytokines, Insulin Resistance and Chronic HCV Infection

References

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[2]	Hui JM, Sud A, Farrell GC, Bandara P, et al (2003): Insulin resistance is associated with chronic hepatitis C virus infection and fibrosis progression. Gastroenterology; 125: 1695-704.
[3]	Gentilucci UV, Picardi A, and Pozzilli P (2006): Glucose abnormalities in patients with hepatitis C virus infection: epidemiology and pathogenesis: response to Lecube et al. Diabetes Care; 29 (11): 2558-2559.
[4]	Simo R, Lecube A, Genesca, Esteban JR, and Hernandez C (2006): Sustained Virological Response Correlates With Reduction in the Incidence of Glucose Abnormalities in Patients with Chronic Hepatitis C Virus Infection. Diabetes Care; 29 (11): 2462-66.
[5]	Delgado-Borrego A, Casson D, Schoenfeld D, Ma S, Adam T, Sergio JH et al (2004): Hepatitis C virus is independently associated with increased insulin resistance after liver transplantation. Transplantation; 77 (5): 703-10.
[6]	Mahmoud HM (2005): Prevalence of insulin resistance in non-diabetic HCV patients. (Master’s thesis). Ain Shams University.
[7]	Lecube A, Cristina Hernández, Joan Genescà and Rafael Simó (2006): Glucose Abnormalities in Patients with Hepatitis C Virus Infection. DiabetesCare; 29 (5): 1140-9 (a).
[8]	Yudkin JS, Stehouwer CD, Emeis JJ, Coppack SW (1999): C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol; 19: 972-8.
[9]	Oyanagi Y, Takahashi T, Matsui S, Takahashi S, Boku S, Takahashi K et al (1999): Enhanced expression of interleukin-6 in chronic hepatitis C. Liver.; 19 (6): 464-72.
[10]	Kasprzak A, Seidel J, Spachacz R, Biczysko W, Makowska A, Kaczmarek E et al. (2004): Intracellular expression of pro-inflammatory cytokines (IL-1, TNF-α, and IL-6) in chronic hepatitis C. Roczniki Akademii Medycznej w Biaymstoku; 49: 207-9.
[11]	Fernandez-Real JM, Vayreda M, Richart C, Gutierrez C, Broch M, Vendrell J et al (2001): Circulating Interleukin 6 Levels, Blood Pressure, and Insulin Sensitivity in Apparently Healthy Men and Women. The Journal of Clinical Endocrinology & Metabolism; 86 (3): 1154-59.
[12]	Vozarova B, Weyer C, Hanson K, Tataranni P, Bogardus C and Pratley RE (2001): Circulating Interleukin-6 in relation to Adiposity, Insulin Action, and Insulin Secretion. Obes Res.; 9: 414–17.
[13]	Lecube A, Hernández C, Genescà J and Simó R. (2006) Proinflammatory cytokines, insulin resistance, and insulin secretion in chronic hepatitis C patients: a case-control study. Diabetes Care; 29: 1096-101 (b).
[14]	Dumoulin FL, Wennrich U, Nischalke HD Leifeld L, Fischer HP, Sauerbruch T et al (2001): Intrahepatic mRNA levels of interferon gamma and tumor necrosis factor alpha and response to antiviral treatment of chronic hepatitis C. J Hum Virol; 4: 195-99.
[15]	Knobler H, Zhornicky T, Sandler A, Haran N, Ashur Y and Schattner A (2003): TNF- induced insulin resistance may mediate the HCV-diabetes association. Am J Gastroenterol; 98: 2751–6.
[16]	Aytug S, Reich D, Sapiro L E, Bernstein D and Begum N (2003): Impaired IRS-1/PI3-kinase signaling in patients with HCV: a mechanism for increased prevalence of type 2 diabetes. Hepatology; 38: 1384-92.
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[18]	Knobler H and Schattner A (2005): TNF-α chronic hepatitis C and diabetes: a novel triad QJM; 98 (1): 1-6.

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APA Style

Nouman Mohammed Elgarem, Mohammad Ahmad Elghobary, Rasha Hamed El Sherif, Maha Assem Hussien, Yousra Hamed Mourad. (2016). Role of Inflammatory Cytokines in Insulin Resistance Among Chronic Hepatitis C Patients. American Journal of Internal Medicine, 4(5), 79-84. https://doi.org/10.11648/j.ajim.20160405.11

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ACS Style

Nouman Mohammed Elgarem; Mohammad Ahmad Elghobary; Rasha Hamed El Sherif; Maha Assem Hussien; Yousra Hamed Mourad. Role of Inflammatory Cytokines in Insulin Resistance Among Chronic Hepatitis C Patients. Am. J. Intern. Med. 2016, 4(5), 79-84. doi: 10.11648/j.ajim.20160405.11

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AMA Style

Nouman Mohammed Elgarem, Mohammad Ahmad Elghobary, Rasha Hamed El Sherif, Maha Assem Hussien, Yousra Hamed Mourad. Role of Inflammatory Cytokines in Insulin Resistance Among Chronic Hepatitis C Patients. Am J Intern Med. 2016;4(5):79-84. doi: 10.11648/j.ajim.20160405.11

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@article{10.11648/j.ajim.20160405.11,
  author = {Nouman Mohammed Elgarem and Mohammad Ahmad Elghobary and Rasha Hamed El Sherif and Maha Assem Hussien and Yousra Hamed Mourad},
  title = {Role of Inflammatory Cytokines in Insulin Resistance Among Chronic Hepatitis C Patients},
  journal = {American Journal of Internal Medicine},
  volume = {4},
  number = {5},
  pages = {79-84},
  doi = {10.11648/j.ajim.20160405.11},
  url = {https://doi.org/10.11648/j.ajim.20160405.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20160405.11},
  abstract = {Insulin resistance plays an essential role in the pathogenesis of diabetes associated with HCV. High levels of inflammatory cytokines have been found in HCV-infected patients. The aim of the study was to investigate the association of HCV infection with impaired glucose metabolism and to highlight the role of inflammatory cytokines as an initial mechanism involved in insulin resistance development in HCV infection. It included 3 groups of patients: Group I: 50 HCV patients with DM. Group II: 50 HCV patients without DM and Group III: 25 patients with DM alone as control subjects. Insulin resistance was evaluated using the (HOMA - IR) index. We measured the levels of fasting insulin, CRP and two of the inflammatory cytokines of the innate immunity (TNF-α and IL-6 by ELISA). It was found that insulin resistance, CRP and IL6 in group (I) were significantly higher when compared to group (II) and (III) with P-value < 0.001. CRP in group (II) was significantly higher when compared to group (III) with P-value < 0.05. Serum level of (TNF-α) in group (I) was significantly higher when compared to group (II) with P-value < 0.05 and group (III) with P-value < 0.001 as well as in group (II) it was significantly higher when compared to group (III) with P-value < 0.001. CRP, IL-6 and TNF-α had statistically significant positive direct correlation to insulin resistance. In conclusion there was a strong relationship between inflammatory cytokines and the occurrence of insulin resistance in chronic HCV patients with type 2 diabetes mellitus.},
 year = {2016}
}

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TY - JOUR
T1 - Role of Inflammatory Cytokines in Insulin Resistance Among Chronic Hepatitis C Patients
AU - Nouman Mohammed Elgarem
AU - Mohammad Ahmad Elghobary
AU - Rasha Hamed El Sherif
AU - Maha Assem Hussien
AU - Yousra Hamed Mourad
Y1 - 2016/08/31
PY - 2016
N1 - https://doi.org/10.11648/j.ajim.20160405.11
DO - 10.11648/j.ajim.20160405.11
T2 - American Journal of Internal Medicine
JF - American Journal of Internal Medicine
JO - American Journal of Internal Medicine
SP - 79
EP - 84
PB - Science Publishing Group
SN - 2330-4324
UR - https://doi.org/10.11648/j.ajim.20160405.11
AB - Insulin resistance plays an essential role in the pathogenesis of diabetes associated with HCV. High levels of inflammatory cytokines have been found in HCV-infected patients. The aim of the study was to investigate the association of HCV infection with impaired glucose metabolism and to highlight the role of inflammatory cytokines as an initial mechanism involved in insulin resistance development in HCV infection. It included 3 groups of patients: Group I: 50 HCV patients with DM. Group II: 50 HCV patients without DM and Group III: 25 patients with DM alone as control subjects. Insulin resistance was evaluated using the (HOMA - IR) index. We measured the levels of fasting insulin, CRP and two of the inflammatory cytokines of the innate immunity (TNF-α and IL-6 by ELISA). It was found that insulin resistance, CRP and IL6 in group (I) were significantly higher when compared to group (II) and (III) with P-value < 0.001. CRP in group (II) was significantly higher when compared to group (III) with P-value < 0.05. Serum level of (TNF-α) in group (I) was significantly higher when compared to group (II) with P-value < 0.05 and group (III) with P-value < 0.001 as well as in group (II) it was significantly higher when compared to group (III) with P-value < 0.001. CRP, IL-6 and TNF-α had statistically significant positive direct correlation to insulin resistance. In conclusion there was a strong relationship between inflammatory cytokines and the occurrence of insulin resistance in chronic HCV patients with type 2 diabetes mellitus.
VL - 4
IS - 5
ER -

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Author Information

Nouman Mohammed Elgarem

Departments of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
Mohammad Ahmad Elghobary

Departments of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
Rasha Hamed El Sherif

Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
Maha Assem Hussien

Departments of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
Yousra Hamed Mourad

Departments of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt

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APA Style

Nouman Mohammed Elgarem, Mohammad Ahmad Elghobary, Rasha Hamed El Sherif, Maha Assem Hussien, Yousra Hamed Mourad. (2016). Role of Inflammatory Cytokines in Insulin Resistance Among Chronic Hepatitis C Patients. American Journal of Internal Medicine, 4(5), 79-84. https://doi.org/10.11648/j.ajim.20160405.11

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ACS Style

Nouman Mohammed Elgarem; Mohammad Ahmad Elghobary; Rasha Hamed El Sherif; Maha Assem Hussien; Yousra Hamed Mourad. Role of Inflammatory Cytokines in Insulin Resistance Among Chronic Hepatitis C Patients. Am. J. Intern. Med. 2016, 4(5), 79-84. doi: 10.11648/j.ajim.20160405.11

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AMA Style

Nouman Mohammed Elgarem, Mohammad Ahmad Elghobary, Rasha Hamed El Sherif, Maha Assem Hussien, Yousra Hamed Mourad. Role of Inflammatory Cytokines in Insulin Resistance Among Chronic Hepatitis C Patients. Am J Intern Med. 2016;4(5):79-84. doi: 10.11648/j.ajim.20160405.11

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@article{10.11648/j.ajim.20160405.11,
  author = {Nouman Mohammed Elgarem and Mohammad Ahmad Elghobary and Rasha Hamed El Sherif and Maha Assem Hussien and Yousra Hamed Mourad},
  title = {Role of Inflammatory Cytokines in Insulin Resistance Among Chronic Hepatitis C Patients},
  journal = {American Journal of Internal Medicine},
  volume = {4},
  number = {5},
  pages = {79-84},
  doi = {10.11648/j.ajim.20160405.11},
  url = {https://doi.org/10.11648/j.ajim.20160405.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20160405.11},
  abstract = {Insulin resistance plays an essential role in the pathogenesis of diabetes associated with HCV. High levels of inflammatory cytokines have been found in HCV-infected patients. The aim of the study was to investigate the association of HCV infection with impaired glucose metabolism and to highlight the role of inflammatory cytokines as an initial mechanism involved in insulin resistance development in HCV infection. It included 3 groups of patients: Group I: 50 HCV patients with DM. Group II: 50 HCV patients without DM and Group III: 25 patients with DM alone as control subjects. Insulin resistance was evaluated using the (HOMA - IR) index. We measured the levels of fasting insulin, CRP and two of the inflammatory cytokines of the innate immunity (TNF-α and IL-6 by ELISA). It was found that insulin resistance, CRP and IL6 in group (I) were significantly higher when compared to group (II) and (III) with P-value < 0.001. CRP in group (II) was significantly higher when compared to group (III) with P-value < 0.05. Serum level of (TNF-α) in group (I) was significantly higher when compared to group (II) with P-value < 0.05 and group (III) with P-value < 0.001 as well as in group (II) it was significantly higher when compared to group (III) with P-value < 0.001. CRP, IL-6 and TNF-α had statistically significant positive direct correlation to insulin resistance. In conclusion there was a strong relationship between inflammatory cytokines and the occurrence of insulin resistance in chronic HCV patients with type 2 diabetes mellitus.},
 year = {2016}
}

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