Association between Serum Vitamin D, Insulin Resistance and Severity of Liver Fibrosis in Chronic Hepatitis C Patients

Authors

  • Soheir Said Kamel Professor of Internal Medicine, Faculty of Medicine, Alexandria University
  • Perihan El Sayed Salem Assistant Professor of Internal Medicine, Faculty of Medicine, Alexandria University
  • Ahmed Swidan Assistant Professor of Internal Medicine, Faculty of Medicine, Alexandria University
  • Sara Ibrahim Specialist of Internal Medicine, Fever Hospital, Alexandria University

Keywords:

Vitamin D, Insulin resistance, HOMA-IR, Liver fibrosis, Acoustic Radiation Force Impulse Imaging, Hepatitis C Virus

Abstract

Liver Fibrosis is a worldwide problem; its diagnosis depends on different modalities as Acoustic Radiation Force Impulse Imaging. Recently, Vitamin D and insulin resistance were linked to liver fibrosis. We aimed to study the association between serum Vitamin D, insulin resistance measured by HOMA-IR and liver fibrosis assessed by Acoustic Radiation Force Impulse Imaging in chronic Hepatitis C patients. The study carried on 60 male patients with chronic Hepatitis C (Group I), and 20 age and sex matched healthy subjects (Group II). All subjects included in this study were subjected to: history taking, routine laboratory investigations, fasting plasma insulin and fasting plasma glucose levels to calculate HOMA-IR, serum Vitamin D level as well as Acoustic Radiation Force Impulse Imaging for assessment of liver fibrosis. HOMA-IR and Acoustic Radiation Force Impulse Imaging readings were significantly high in chronic Hepatitis C patients in comparison to normal controls. On the other hand, serum Vitamin D levels were evidently low among Hepatitis C patients in comparison to normal controls. Acoustic Radiation Force Impulse Imaging, HOMA-IR and serum Vitamin D levels have high ability for the diagnosis of liver fibrosis in Hepatitis C patients.

References

• Abdel-Aziz F, Habib M, Mohamed MK, Abdel-Hamid M, Gamil F, Madkour S, et al. Hepatitis C virus (HCV) infection in a community in the Nile Delta: population description and HCV prevalence. Hepatology 2000; 32: 111–5.

• Baur K, Mertens JC, Schmitt J, Iwata R, Stieger B, Eloranta JJ, et al. Combined effect of 25-OH vitamin D plasma levels and genetic vitamin D receptor (NR 1I1) variants on fibrosis progression rate in HCV patients. Liver Int 2012; 32: 635–43.

• Bode JG, Brenndörfer ED, Häussinger D. Subversion of innate host antiviral strategies by the hepatitis C virus. Arch Biochem Biophys 2007; 462[2]: 254-65.

• Castéra L, Vergniol J, Foucher J. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 2005; 128: 343–50.

• Croquet V, Vuillemin E, Ternisien C, Pilette C, Oberti F, Gallois Y, et al. Prothrombin index is an indirect marker of severe liver Fibrosis. Eur J Gastroenteral Hepatol 2002; 14: 1133- 41.

• Daly RM, Gagnon C, Lu ZX, Magliano DJ, Dunstan DW, Sikaris KA. Prevalence of vitamin D deficiency and its determinants in Australian adults aged 25 years and older: a national, population-based study. Clin Endocrinol 2012; 77: 26–35.

• El Said HI, Ashraf NE, Fathallah SM, Perihan ES, Sarah FM. Study of hepatic stiffness in hepatitis C virus-related liver diseases by acoustic radiation force impulse imaging. Egyptian Liver J 2014; 4[3]: 79–82.

• Faisal MS, Ali B, Hussa AH, Suhail A, Osama A, Ayman AA, et al. Is serum transaminase level a reliable marker of histological disease in chronic Hepatitis C infection. Liver Int 2008; 28[7]: 1011-8.

• Frank C, Mohamed MK, Strickland GT, Lavanchy D, Arthur RR, Magder LS, Elkhoby T, Abdel-wahab Y, Aly Ohn ES, Anwar W, Sallam I. The role of parentral antishistosomal therapy in the spread of hepatitis C virus in Egypt. Lancet 2000; 355: 887-91.

• Friedman SL. Liver fibrosis-from bench to bedside. J Hepatol 2003; 38: 38–53.

• Friedrich-Rust M, Wunder K, Kriener S, Sotoudeh F. Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology 2009; 252: 595–604.

• Gandhe MB, Jain K, Gandhe SM. Evaluation of 25 (OH) Vitamin D3 with Reference to Magnesium Status and Insulin Resistance in T2DM. JCDR 2013; 7[11]: 2438.

• García-Ãlvarez M, Pineda-Tenor D, Jiménez-Sousa MA, Fernández-Rodríguez A, Guzmán-Fulgencio M, Resino S. Relationship of vitamin D status with advanced liver fibrosis and response to hepatitis C virus therapy: a meta-analysis. Hepatology 2014; 60: 1541–50.

• Hanley AJG, Williams K, Gonzalez C, Wagenknecht LE, Stern MP, Haffner SM, et al. prediction of type 2 diabetes using simple measure of insulin resistance. Diabetes 2003; 52: 463-9.

• Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011; 96: 1911–30.

• Kawaguchi T, Yoshida T, Harada M, Hisamoto T, Nagao Y, Ide T, et al. Hepatitis C virus down-regulates insulin receptor substrates 1 and 2 through up-regulation of suppressor of cytokine signaling 3. Am J Pathol 2004; 165[5]: 1499-508.

• Kochupillai N. The physiology of vitamin D: Current concepts. Indian J Med Res 2008; 127: 256-62.

• Kumar D, Farrell GC, Fung C. Hepatitis C virus genotype 3 is cytopathic to hepatocytes: Reversal of hepatic steatosis after sustained therapeutic response. Hepatology 2002; 36: 1266–72.

• Le Roith D, Zick Y. Recent advances in our understanding of insulin action and insulin resistance. Dia Care 2001; 24: 588-97.

• Lips P. Vitamin D physiology. Prog Biophys Mol Biol 2006; 92: 4-8.

• Maeno T, Okumura A, Ishikawa T. Mechanisms of increased insulin resistance in non-cirrhotic patients with chronic hepatitis C virus infection. J Gastroenterol Hepatol 2003; 18: 1358- 63.

• Mariana CS, Telma ES, Maria LA, Mara SP, Letica MW, David AG, et al. Factors associated with 25-hydroxyvitamin D levels in patients with liver cirrhosis. Ann Hepatol 2015; 14: 99-107.

• Marra F. Hepatic stellate cells and the regulation of liver inflammation. J Hepatol 1999; 31: 1120–30.

• Miller FD, Abu Raddad LJ. Evidence of intense ongoing endemic transmission of hepatitis C virus in Egypt. Proc Natl Acad Sci USA 2010; 107[33]: 14757-62.

• Paradis V, Perlemuter G, Bonvoust F. High glucose and hyperinsulinemia stimulate connective tissue growth factor expression: a potential mechanism involved in progression to fibrosis in nonalcoholic steatohepatitis. Hepatology 2001; 34: 738–44.

• Perrillo R. The role of liver biopsy in hepatitis C. Hepatology 1997; 26[1]: 57-61.

• Petta S, Cammà C, Scazzone C, Tripodo C, Di Marco V, Bono A, et al. Low vitamin D serum level is related to severe fibrosis and low responsiveness to interferon-based therapy in genotype 1 chronic hepatitis C. Hepatology 2010; 51: 1158–67.

• Poynard T, Cacoub P, Ratziu V, Myers RP, Dezailles MH, Mercadier A, et al. Fatigue in patients with chronic hepatitis C. J Viral Hepat 2002; 9[4]: 295-303.

• Putz-Bankuti C, Pilz S, Stojakovic T, Scharnagl H, Pieber TR, Trauner M, et al. Association of 25-hydroxyvitamin D levels with liver dysfunction and mortality in chronic liver disease. Liver Int 2012; 32: 845–51.

• Sporea I, Sirli R, Popescu A, Danila M. Acoustic Radiation Force Impulse (ARFI) a new modality for the evaluation of liver fibrosis. Med Ultrason 2010; 12: 26-31.

• Stephen L,Timothy R. The Natural History of Hepatitis C Virus (HCV) Infection. Int J Med Sci 2006; 3[2]: 47–52.

• Stokes CS, Volmer DA, Grunhage F. Vitamin D in chronic liver disease. Liver International 2013; 33: 338-52.

• Streiff MB, Mehta S, Thomas DL. Peripheral blood count abnormalities among patients with hepatitis C in the United State. Hepatology 2002; 35: 947-52.

• Su-Mei L, Guang-Xia L, Dong-Mei F, Yu W, Li Qun D. Liver fibrosis evaluation by ARFI and APRI in chronic hepatitis C. World J Gastroenterol 2014; 20[28]: 9528–33.

• Takiishi T, Gysemans C, Bouillon R, Mathieu C. Vitamin D and diabetes. Endocrinology and Metabolism Clinics of North America 2010; 39: 419–46.

Downloads

Published

2018-04-25

How to Cite

Kamel, S. S., Salem, P. E. S., Swidan, A., & Ibrahim, S. (2018). Association between Serum Vitamin D, Insulin Resistance and Severity of Liver Fibrosis in Chronic Hepatitis C Patients. Asian Journal of Applied Sciences, 6(2). Retrieved from https://ajouronline.com/index.php/AJAS/article/view/5280

Issue

Vol. 6 No. 2 (2018): April 2018

Section

Articles

License

  • Papers must be submitted on the understanding that they have not been published elsewhere (except in the form of an abstract or as part of a published lecture, review, or thesis) and are not currently under consideration by another journal published by any other publisher.
  • It is also the authors responsibility to ensure that the articles emanating from a particular source are submitted with the necessary approval.
  • The authors warrant that the paper is original and that he/she is the author of the paper, except for material that is clearly identified as to its original source, with permission notices from the copyright owners where required.
  • The authors ensure that all the references carefully and they are accurate in the text as well as in the list of references (and vice versa).
  • Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Attribution-NonCommercial 4.0 International that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  • Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  • Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
  • The journal/publisher is not responsible for subsequent uses of the work. It is the author's responsibility to bring an infringement action if so desired by the author.