<<snip>>
significantly higher level of TNFalpha and ferritin which may explain
their insulin resistance
<<snip>>

Curr Med Res Opin. 2005 Apr;21(4):527-34. Related Articles, Links

Elevated serum tumor necrosis factor alpha and ferritin may contribute
to the insulin resistance found in HCV positive Egyptian patients.

Elsammak M, Refai W, Elsawaf A, Abdel-Fattah I, Abd Elatti E, Ghazal A.

Department of Chemical Pathology, Medical Research Institute,
Alexandria University, Egypt. myelsammak@doctors.org.uk

OBJECTIVE: There is evidence of an increased incidence of insulin
resistance and diabetes mellitus (DM) in patients with hepatitis C
virus (HCV) infection. Several mechanisms have been proposed, including
inadequate insulin secretion or interference with signaling within the
insulin receptor. We assessed serum tumor necrosis factor alpha
(TNFalpha) and ferritin levels as potential mediators of insulin
resistance in HCV positive Egyptian patients. PATIENTS AND RESULTS:
Patients (n = 27) with HCV infection, patients (n = 23) with hepatitis
C and DM (HCV + DM), patients (n = 22) with DM, and sex- and
age-matched controls (n = 18) were included in this study. The degree
of insulin resistance (HOMA index) was significantly higher in the HCV,
HCV + DM and DM groups compared to the controls. The mean +/- SD of the
HOMA index was 4.53 +/- 2.84, 6.1 +/- 2.36, 3.69 +/- 2.2 and 1.32 +/-
0.49, in HCV, HCV + DM, DM and controls, respectively. Serum TNFalpha
levels were significantly higher in the HCV, HCV + DM groups compared
with the healthy controls and DM patients (p < 0.001). The median
(range) values of TNFalpha in HCV, HCV + DM, DM patients and controls
subjects were 25.5 (0.43-124.0), 19.8 (0.51-139), 0.85 (0-10.5) and
0.32 (0-5.8) pg/mL, respectively. There was a significant positive
correlation between the HCV load and both HOMA index and TNF alpha
level. HCV and HCV + DM patients also had significantly higher serum
ferritin levels compared with healthy controls and patients with DM.
The mean +/- SD of serum ferritin in HCV, HCV + DM, DM patients and
controls subjects was 258.1 +/- 116.2, 285.8 +/- 124.3, 86.9 +/- 41.8
and 159.9 +/- 76.9 ng/mL, respectively. CONCLUSION: Patients with HCV
infection had a significantly higher level of TNFalpha and ferritin
which may explain their insulin resistance. HOMA index and serum
TNFalpha levels correlated positively with the HCV load.

PMID: 15899101 [PubMed - in process]

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