Abstract:
Introduction: It is now debated question about the combination of
chronic viral hepatitis C with insulin resistance (IR). Meanwhile, studies
identifying IR in chronic hepatitis B (CHB) are rare. The aim: Study of
IR development during the dynamic test of stimulation with glucose and
euphylline (STGE) in dependence on the transaminazes activity in patients
with CHB. Material and methods: We examined 186 patients with
CHB, the average age 35.44 ± 5.34 years. Patients with ALT levels < 2N
– 104 (55.92%) and with increased ALT level > 2N – 82 (44.09%). The
presence of IR was detected by HOMA index, on empty stomach, and in
the dynamics (60 and 120 min) of the stimulation test with glucose load
(50 g) and euphyllin (0.5 g) per os in 150 ml of water. Control group (CG)
served 34 healthy individuals without obesity. The results: In CHB with
ALT < 2N, HOMA index fasting didn’t differ from that in CG. But at 60
and 120 minutes of STGE showed a signifi cant increase of HOMA (10.18
± 0.022 and 10.79 ± 0.02) in comparison to CG (6.89 ± 0.006; p < 0.001
and 1.82 ± 0.003; p < 0.001.) In CHB with ALT > 2N, HOMA was signifi
cantly higher at 60 and 120 minutes of STGE (13.43 ± 0.07, p < 0.001
and 14.67 ± 0.002, p < 0.001) compared to CG patients with CHB with
minimum activity. Conclusion: The proposed method for the study of
the HOMA index in the dynamics of stimulation test with glucose and
euphylline allows early diagnosis of the insulin resistance presence in
chronic hepatitis B.