Higher HCC risk with increased insulin resistance

[nygirl7]

Just FYI - if you have IR you might want to also keep on top of this one too.

Better safe than sorry....I don't want to be the harbinger of doom but I know IR is a problem for some folks around here. I hate HCC if you can't tell.....no more of my friends should die of this.

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Higher HCC risk with increased insulin resistance in hepatitis C patients
May 12, 2010

Recent studies have demonstrated that type 2 diabetes mellitus (DM) is associated with high risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C. Insulin resistance (IR), which correlates inversely with circulating adiponectin concentration, is a consistent finding in patients with type 2 DM. Chronic hepatitis C virus (HCV) infection has been reported to be associated with increased IR. Recent studies suggest that IR plays a crucial role in fibrosis progression, and has been demonstrated to have a negative impact on treatment responses to antiviral therapy in patients with chronic hepatitis C.


A research article to be published on May 14, 2010 in the World Journal of Gastroenterology addresses this question. The research team led by Dr. Hung from Kaohsiung Chang Gung Memorial Hospital prospectively investigated the IR assessed by the homeostasis model (HOMA-IR) and serum adiponectin level in two independent cohorts of consecutive newly diagnosed HCC patients and those with different clinical stages of chronic HCV infection.

Among 165 HCC patients, type 2 DM was more prevalent in HCV subjects compared to hepatitis B virus (HBV) or non-HBV, non-HCV cases. HOMA-IR was higher in HCC patients with HCV than in those with HBV infection. In 188 patients with chronic hepatitis C, HCC subjects had higher blood sugar, insulin level and HOMA-IR than those with chronic hepatitis and advanced fibrosis.

Based on stepwise logistic regression analysis, HOMA-IR was one of the independent factors associated with HCC development. This result was similar even if the diabetic subjects were excluded for analysis. The research team concluded that increased IR, regardless of the presence of diabetes, is significantly associated with HCC development in patients with chronic HCV infection.

These findings may have important prognostic and therapeutic implications in the management of chronic HCV-infected patients. Since IR is a potentially modifiable factor, therapeutic intervention aimed at decreasing IR may be warranted in these patients.

More information: Hung CH, Wang JH, Hu TH, Chen CH, Chang KC, Yen YH, Kuo YH, Tsai MC, Lu SN, Lee CM. Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection. World J Gastroenterol 2010; 16(18): 2265-2271 http://www.wjgnet.com/1007-9327/full/v16/i18/2265.htm

Provided by World Journal of Gastroenterology (news : web)

http://www.physorg.com/news192880615.html

[susan400]

My A1C's for the past year have ALWAYS been normal.  So, with that in mind, even though I've had a few blood sugars that were just barely over the cuttoff..., like 106, 102, 105,101..., my doctor is not calling me a diabetic, or even a pre-diabetic since he says the gold standard is the A1C and mine is always excellent on that front.  He's run this A1C over and over and over again, (I think he thinks if he runs it often enough that he's going to be able to call me diabetic, LOL).  NOT!  I asked him specifically, do I need to have a fasting GTT and he said no because he wouldn't change anything treatment-wise on what he'd do with me.  He said if I had an abnormal fasting GTT that the next normal step is always an A1C and since mine is always normal, that there's no reason to run a fasting GTT..., he says that would be a waste of my time and a waste of money.  This guy is an internal medicine doctor, so I am pretty sure that he knows his stuff.  Also, I might add that he's in the same group as my hepatologist and they have access to each other's records on the computer and actually talk to each other.  So, I'm fairly confident that I don't have IR.  I do thank you though, for publishing this fact.  It is something to keep in mind.

Take care, Susan400

[nygirl7]

Right now it's like the one darn thing that doesn't apply to me but I am going to keep my eye on it in the future because everything else seems to be going kerplonk now that I"m uh over 20.

[jusjames]

its worth checking even for skinny people ,

[Trinity4]

Interesting read and likely IR could apply to me.  That is one of the things I'll have checked out before treating again.