Predicting Esophageal Varices in Cirrhotic Hepatitis C Virus Patients Using Noninvasive Measurement of Insulin Resistance Variables

Author(s): Elsaid Wasfy, Galal Elkassas, Sally Elnawasany, Kariman Elkasrawy, Sherief Abd-Elsalam*, Shaimaa Soliman, Rehab Badawi

Journal Name: Endocrine, Metabolic & Immune Disorders - Drug Targets
Formerly Current Drug Targets - Immune, Endocrine & Metabolic Disorders

Volume 18 , Issue 6 , 2018

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Graphical Abstract:


Background& Aims: Esophageal varices (EV) are a major complication of portal hypertension in cirrhotic patients. Screening is essential for all patients with cirrhosis. Performing non-invasive methods for screening is a cost-effective and time-saving measure. The aim of this work is to evaluate whether insulin resistance (IR) assessed by HOMA-IR score can predict the presence of EV or not.

Methods: This cross-sectional study was carried out on sixty Egyptian cirrhotic HCV patients divided into 3 groups: Group I: 20 cirrhotic patients without esophageal varices, Group II: 20 cirrhotic patients, with small esophageal varices and Group III: 20 cirrhotic patients with large esophageal varices. Fasting insulin level was measured and HOMA- IR score was calculated. Abdominal ultrasound and Fibroscan were done to all patients.

Results: Insulin resistance assessed by HOMA –IR score showed a statistically significant difference among the three groups (P<0.001) with a cutoff value equal to or more than 3.40. It could significantly predict EV (AUROC= 0.841) with high sensitivity of 75 %, and excellent specificity 80%. Liver stiffness measurement (LSM) with a cutoff value 40.95 kPa could significantly predict EV (AUROC= 0.629) with sensitivity 75 %, specificity 50 %.

Conclusion: HOMA-IR score is a new independent predictor of the presence of EV.

Keywords: Insulin resistance, esophageal varices, HOMA-IR score, non-invasive, cirrhotic hepatitis C virus, portal hypertension.

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Article Details

Year: 2018
Published on: 04 October, 2018
Page: [573 - 580]
Pages: 8
DOI: 10.2174/1871530318666180803120428
Price: $65

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