Insulin Resistance and beta Cell Function in Patients with Chronic Hepatitis and Impaired Glucose Tolerance

HBV and HCV infections play an important role in the pathogenesis of patients with diabetes. The aim of this study was to determine changes in blood glucose, insulin resistance and beta cell function in IGT patients with chronic hepatitis B and C. Materials and Methods: A group of 560 patients with IGT, chosen from among participants of the Tehran Glucose and Lipid Study, were enrolled in this survey; their sera were examined in stage I for hepatitis B and C. FBS, HOMA-IR, beta cell function in the three groups (hepatitis B, C and seronegative) were studied, and these evaluations were repeated after 3 years. The changes over three years were quantitatively calculated by means of T tests paired T test. X2 and the MC Nemar test ANOVA variance analysis were used for qualitative variables (for determination of variable effects). Spearman and Pearson correlation coefficients were used to find relationship between variables. Results: Of participants, 64.9% were female and 35.1% male; their average age was 50.8 +/- 12.7 years at the beginning of the study. There was no significant difference for FBS, HOMA-IR, beta cell function between the 3 groups. After three years, six of them were HCV positive and six were HBV positive. There was no significant difference between their FBS, HOMA-IR and beta CF after 3 years. Blood glucose changes and beta cell function in persons that were positive for HBV or HCV in the first and second stages of the study showed no significant statistical change after three years, whereas HOMA-IR showed significant reduction compared to the beginning of study (from 4 +/- 2 to 3.1 +/- 2.2, p<0.05). In general, in persons that were seronegative for HBV or HCV in both stages of this study, significant changes were observed in different degrees of insulin resistance after three years; 22.5% of persons sensitive to insulin became resistant, while 49.6% of them became sensitive (p<0.001), changes that were not observed in seropositive patients. Conclusion: There was no significant statistical difference between the seropositive group for changes in blood glucose, HOMA IR, and beta cell function after 3 years whereas in the seronegative patients, blood glucose increased and beta cell function and HOMA-IR decreased.