Cryptogenic cirrhosis: Metabolic liver disease due to insulin resistance.
Indian J Med Sci
;
2010 Nov; 64(11) 508-519
Article
in English
| IMSEAR
| ID: sea-145573
ABSTRACT
Objective:
Etiopathogenesis of cryptogenic cirrhosis (CC) is not yet well established. Up to 20% of non-alcoholic fatty liver disease (NAFLD) may progress to cirrhosis, mostly termed as cryptogenic. Insulin resistance and altered metabolic parameters form a major pathogenic link between NAFLD and CC. CC may thus be actually a metabolic liver disease. Materials andMethods:
Thirty-four patients of CC and 32 patients having cirrhosis due to chronic hepatitis B (Hep B) were assessed in a cross-sectional study in a tertiary hospital for insulin resistance, % β-cell activity, obesity indices, plasma glucose, lipid profiles, and many other parameters.Results:
CC patients had higher homeostasis model assessment (HOMA)-IR compared to Hep B group (P = 0.000016). A positive correlation between IR values and Child-Pugh score among CC patients was found ("r" = 0.87; P < 0.00001). Out of 34 CC patients, 15 (44.1%) had obesity contrary to 6 (18.8%) in the control group (P = 0.0022). Differences were observed in subcutaneous fat (P = 0.0022), intra-abdominal fat (P = 0.0055), waist circumference (P = 0.014), and percentage body fat (P = 0.047) between the two groups. Significant differences were observed in the levels of triglyceride, total cholesterol, and very low density lipoprotein (VLDL).Conclusion:
Most of the CC patients showed significantly higher prevalence of HOMA-IR, obesity indices, and various parameters of "lipotoxicity" and metabolic syndrome, suggesting that CC may be the long-term consequence of a type of "metabolic liver disease." Further studies are required to evaluate the role of therapeutic interventions to enhance insulin sensitivity in such patients.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Time
/
Body Weights and Measures
/
Female
/
Humans
/
Male
/
Insulin Resistance
/
Cross-Sectional Studies
/
Risk Factors
/
Statistics as Topic
/
Hepatitis B, Chronic
Type of study:
Etiology study
/
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Language:
English
Journal:
Indian J Med Sci
Year:
2010
Type:
Article
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