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A simple fibrosis index can be useful to select hepatitis C virus-infected patients with a very low risk of significant fibrosis in whom the protocol of liver biopsies may be avoided.

Objective: Great interest is directed to inflammation and oxidative stress involvement in type 2 diabetes pathogenesis. Many researchers suggest they play roles but exactly how is still not clear enough. This encouraged us to investigate relations and potential inter-relationships between them and insulin resistance in type 2 diabetes in its early stage. Whether metformin drug alone, as frequently prescribed, is enough for type 2 diabetes management in this early stage was also an objective.Methods: Blood sugar indices, adiponectin (ADIPOQ), tumor necrosis factor-α (TNF-α), malondialdehyde (MDA), nitric oxide (NO), C-reactive protein (CRP), liver and kidney function tests and lipid profile were monitored in non-diabetic volunteers, pre-diabetic and newly diagnosed type 2 diabetic patients before and after metformin drug utilization for 5 mo.Results: MDA, inflammation markers and alanine aminotransferase (ALT) were elevated, and blood sugar indices and lipid profile showed pathological alterations in diabetics compared to non-diabetics; changes were worse in type 2 cases. They were improved to different degrees by metformin treatment except for pancreatic β-cells function and ADIPOQ level showed no significant improvements and it couldn't normalize ALT. Conclusion:Results reflected significant relations and inter-relationships between oxidative stress and inflammation markers in type 2 diabetes in its early stage and indicated that metformin may need to be combined with another drug.

Background: Lately, several studies have utilized non-invasive serological markers to assess liver fibrosis and some are currently being validated as potential tools to determine liver damage. Purpose: Our aim was to investigate the diagnostic performance of AFP, autotoxin and collagen IV as non-invasive biomarkers of hepatic fibrosis. Patients and methods: 45 males and 15 females with chronic hepatitis C were enrolled in the current study. Laboratory assessment was done for all subjects in form of complete blood picture, liver function test, alpha fetoprotein (AFP), collagen IV and autotaxin. Patients were grouped according to the stage of fibrosis into F1, F2 and F3. Results: Mean serum values of AFP, autotaxin and collagen IV were elevated in all patients compared to healthy controls. Surprisingly, with increasing fibrosis stage AFP showed non-significant change while collagen IV and autotoxin showed significant increase (P less than 0.01 and P less than 0.0001, respectively). Autotaxin and collagen IV were significantly (P less than 0.01 and P less than 0.05, respectively) lower in F1 patients than those with F2-F3 but AFP level showed non-significant change. Autotaxin had the highest area under ROC curve and the highest accuracy for discrimination of F1 from F2-F3 patients and for discrimination of patients with F3 from F1-F2. Different combinations between AFP, collagen IV and autotoxin showed improvement in the accuracy. Conclusion: It was concluded that serum autotaxin may at least serve as a new clinical non-invasive alternative in patients who are not candidates for liver biopsy for diagnosis of liver damage. Autotaxin combination with collagen IV and AFP addition make them more useful.

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