KRONİK HEPATİT B HASTALARINDA İNSULİN DİRENCİ SIKLIĞI
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Tarih
2015
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info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada kronik hepatit B hepatiti tanısı olan hastalarda insülin rezistansı sıklığı ile karaciğer biyopsisinde saptanan fibrozis üzerine etkisini değerlendirmek amaçlanmıştır. Metod: 2010-2012 yılları arasında kronik viral hepatit B tanısı ile takip edilen ve karaciğer biyopsisi yapılan 52 hasta değerlendirildi. Tüm hastalarda tam kan sayımı, glukoz ve biyokimya tetkikleri, hepatit belirteçleri, Hepatit B Virüs DNA düzeyleri çalışıldı. Vücut kitle indeksi (kg/m2) ve insülin direnci (HOMA-IR) [açlık insülin (µU/mL) X AKŞ (mmol/L)] / 22.5 olarak hesaplandı. Karaciğer histo- lopatolojisi histolojik aktivite indeksi ve fibrozis yönünden Ishak sınıflamasına göre değerlendirildi. Bulgular: Çalışmadaki 52 hastanın 34inde (%65) insulin direnci mevcuttu. İnsulin direnci olan kronik HBV hastaları ile insulin direnci olmayan Hepatit B Virüs (HBV) hastaları arasında yaş, Alanin Aminotransferaz (ALT), Aspartat Aminotransferaz (AST), fibrozis ve histolojik aktivite indeksi açısından anlamlı fark saptanmadı. Bununla birlikte insulin direnci olan kronik HBV hastalarının insulin direnci olmayan Hepatit B Virüs (HBV) hastalarına göre istatistiksel olarak anlamlı olarak yüksek Vücut Kitle İndeksi (BMİ) ve düşük Hepatit B Virüs DNA değerlerine sahip oldukları görüldü. Sonuç: İnsulin direnci kronik hepatit B hastalarında sıklıkla saptanmaktadır. Kronik hepatit B hastalarında insulin direnci araştırılmalı ve bu hastalara diabetes mellutis hakkında bilgi verilmelidir.
Objective: This study was performed to determine the frequency of insulin rezistance among patients with chronic hepatitis B and to demonstrate the association with biopsy proven liver fibrosis. Methods: A group of 52 patients who had undergone liver biopsy for chronic hepatitis B between 2010 and 2012 were evaluated. In all cases, complete blood count, serum fasting glucose, and basic biochemical tests, hepatitis markers, hepatitis B virus DNA levels were performed. The body mass index was calculated as kg/m2 and the insulin resistance was calculated as (HOMA-IR) [fasting insulin (µU/mL) X fasting blood glucose (mmol/L)] / 22.5. Results: Of 52 patients who chronic hepatitis B infection, 34 had insulin resistance. When the chronic hepatitis B patients with and without insulin resistance were compared, there was no significant difference between the groups in terms of age, ALT, AST, fibrosis and Histologic Activity Index. However, chronic hepatitis B patients with insulin resistance had significantly higher levels of BMI and lower levels of HBV DNA. Conclusion: Insulin resistance is firuquently seen among the patients with chronic hepatitis B. The insulin resistance must be investigated in chronic hepatitis b patients and they must be informed about diabetes mellitus.
Objective: This study was performed to determine the frequency of insulin rezistance among patients with chronic hepatitis B and to demonstrate the association with biopsy proven liver fibrosis. Methods: A group of 52 patients who had undergone liver biopsy for chronic hepatitis B between 2010 and 2012 were evaluated. In all cases, complete blood count, serum fasting glucose, and basic biochemical tests, hepatitis markers, hepatitis B virus DNA levels were performed. The body mass index was calculated as kg/m2 and the insulin resistance was calculated as (HOMA-IR) [fasting insulin (µU/mL) X fasting blood glucose (mmol/L)] / 22.5. Results: Of 52 patients who chronic hepatitis B infection, 34 had insulin resistance. When the chronic hepatitis B patients with and without insulin resistance were compared, there was no significant difference between the groups in terms of age, ALT, AST, fibrosis and Histologic Activity Index. However, chronic hepatitis B patients with insulin resistance had significantly higher levels of BMI and lower levels of HBV DNA. Conclusion: Insulin resistance is firuquently seen among the patients with chronic hepatitis B. The insulin resistance must be investigated in chronic hepatitis b patients and they must be informed about diabetes mellitus.
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4
