The diagnosis of the insulin resistance in chronic hepatitis B using the dynamic test of glucose and euphylline stimulation

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.