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

Wasfy, Elsaid; Elkassas, Galal; Elnawasany, Sally; Elkasrawy, Kariman; Soliman, Shaimaa; Badawi, Rehab

doi:10.2174/1871530318666180803120428

Cited by 17 publications

(11 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hyperglycemia and especially fluctuating blood sugar levels seem to contribute to splanchnic hyperemia and elevated portal pressure, increasing the risk of VH [ 60 , 61 ]. More, there is an important link between IR/HOMA-IR and impaired portal hemodynamics [ 62 , 63 ] and some studies suggested that IR could predict the presence of esophageal varices (EV) with 75% sensitivity and 80% specificity [ 27 , 64 ].…”

Section: Discussionmentioning

confidence: 99%

Association between Liver Cirrhosis and Diabetes Mellitus: A Review on Hepatic Outcomes

Coman

Bădărău

et al. 2021

JCM

View full text Add to dashboard Cite

Background: Liver cirrhosis (LC) is largely associated with diabetes mellitus (DM). More than 80% of patients with LC manifest glucose intolerance and about 30% have type 2 DM. A particular and yet unrecognized entity is hepatogenous diabetes (HD), defined as impaired glucose regulation caused by altered liver function following LC. Numerous studies have shown that DM could negatively influence liver-related outcomes. Aim: We aimed to investigate whether patients with LC and DM are at higher risk for hepatic encephalopathy (HE), variceal hemorrhage (VH), infections and hepatocellular carcinoma (HCC). The impact of DM on liver transplant (LT) outcomes was also addressed. Methods: Literature search was performed in PubMed, Ovid, and Elsevier databases. Population-based observational studies reporting liver outcomes in patients with LC were included. Results: Diabetics are at higher risk for HE, including post-transjugular intrahepatic portosystemic shunt HE. DM also increases the risk of VH and contributes to elevated portal pressure and variceal re-bleeding, while uncontrolled DM is associated with increased risk of bacterial infections. DM also increases the risk of HCC and contributes to adverse LT outcomes. Conclusions: Patients with DM and LC may benefit from close follow-up in order to reduce readmissions and mortality. Due to the heterogeneity of available research, prospective multicenter clinical trials are needed to further validate these findings.

show abstract

Section: Discussionmentioning

confidence: 99%

Association between Liver Cirrhosis and Diabetes Mellitus: A Review on Hepatic Outcomes

Coman

Bădărău

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…Portal hypertension is the most common complication of liver cirrhosis, and esophageal varices are portal mesangium of patients with liver cirrhosis with portal hypertension (19). Every year, a certain proportion of cirrhotic patients develop esophageal varices, which is the main cause of death for cirrhotic patients (20). TIPS is the main treatment method for esophageal varices rupture and hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Clinical effect of single covered stent and double covered stent on TIPS in the treatment of hemorrhage due to rupture of esophageal and gastric varices in cirrhosis and its influence on immune function

Jia

Liu

et al. 2019

Exp Ther Med

View full text Add to dashboard Cite

Clinical effect of single covered stent and double covered stent in transjugular intrahepatic portosystemic shunt (TIPS) in the treatment of hemorrhage due to rupture of esophageal and gastric varices in cirrhosis and its influence on the immune function of patients was investigated. Altogether 124 patients with liver cirrhosis and esophageal and gastric varices bleeding who were admitted to the First People's Hospital of Neijiang from February 2012 to April 2016 were selected as research objects and divided into group A and B. Group A (65 cases) was treated with simple covered stent, and group B (59 cases) was treated with double covered stent simulating Viatorr technique. The therapeutic effect of the two groups after operation was observed. The changes of portal vein pressure before and after treatment and the changes of esophageal and gastric varices after operation were observed. The levels of peripheral blood T lymphocyte subsets (CD3+, CD4+ and CD4+/CD8+) were detected by flow cytometry. The therapeutic effect of group B was higher than that of group A (P>0.05). The postoperative portal vein pressure in group B was significantly lower than that in group A (P<0.05). The disappearance rate and overall effective rate of varicose veins in group B were better than those in group A (P>0.05). After three days of treatment, the levels of CD3+, CD4+, CD4+/CD8+ in the peripheral blood of group B were higher than those of group A (P>0.05), while the decline rate of CD3+, CD4+, CD4+/CD8+ in the peripheral blood of group B was higher than that of group A after seven days of treatment. Double-stent simulated Viatorr has a higher effective rate, has a certain improvement on the immune function of patients, and the survival rate is also higher than that of single covered stent, which is worthy of clinical application and promotion.

show abstract

“…Another small study 15 (n = 60) recorded IR measured by HOMA-IR in HCV patients. HOMA-IR was higher in patients with oesophageal varices compared to those without.…”

Section: Discussionmentioning

confidence: 99%

“…The number of enrolled patients (n = 146) in our study was higher than in others. 12–15 We used the HOMA-IR model in accordance with other studies, 12,13,15 unlike others 13,14 who used the HOMA2-IR model. All our patients had HCV and compensated cirrhosis while other studies had a mixed aetiology, 13 alcoholic hepatitis 14 or decompensated cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Insulin resistance is not a risk factor for oesophageal varices development in hepatitis C

Alsebaey

Elhelbawy

2019

Trop Doct

View full text Add to dashboard Cite

Chronic hepatitis C (HCV) patients commonly have insulin resistance which is a risk factor for disease progression. Oesophageal varices may bleed with high mortality. We aimed to assess the relationship between insulin resistance and oesophageal varices. HCV-related compensated liver cirrhosis patients (n = 146) underwent gastroscopy and homeostasis model assessment (HOMA)-IR, HOMA-β and HOMA-S calculations. Their average age was 54.98 years; most (84.9%) patients were men and non-diabetic (60.3%). Patients with oesophageal varices had higher median Model for End-Stage Liver Disease (MELD) scores and comparable Child-Pugh class. Patients with and without oesophageal varices had comparable ( P > 0.05) HOMA scores and insulin resistance percentage of 82.9% versus 85.5%. We therefore conclude that insulin resistance is unrelated to the presence of oesophageal varices.

show abstract

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

Abstract: HOMA-IR score is a new independent predictor of the presence of EV.

Cited by 17 publications

References 0 publications

Association between Liver Cirrhosis and Diabetes Mellitus: A Review on Hepatic Outcomes

Association between Liver Cirrhosis and Diabetes Mellitus: A Review on Hepatic Outcomes

Clinical effect of single covered stent and double covered stent on TIPS in the treatment of hemorrhage due to rupture of esophageal and gastric varices in cirrhosis and its influence on immune function

Insulin resistance is not a risk factor for oesophageal varices development in hepatitis C

Contact Info

Product

Resources

About