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

[ Vol. 18 , Issue. 6 ]

Author(s):

Elsaid Wasfy, Galal Elkassas, Sally Elnawasany, Kariman Elkasrawy, Sherief Abd-Elsalam*, Shaimaa Soliman and Rehab Badawi   Pages 573 - 580 ( 8 )

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.

Affiliation:

Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta, Public Health and Community Medicine, Menoufia University, Faculty of Medicine, Menoufia, Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta

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