Insulin-Like Growth Factor-I/ Insulin-Like Growth Factor Binding Protein-3 Ratio As A Predictive Marker For Insulin Resistance In Patients With Chronic Hepatitis C Virus

ABSTRACT: The continuously world-wide growing epidemic of hepatitis-C virus (HCV) and diabetes mellitus type-2 and their closely related relationship merit to be highly studied. Insulin-like growth factor-1 (IGF-1) was found to be decreased in patients with diabetes mellitus as well as in patients with hepatic steatosis. As both hepatic steatosis and insulin resistance were two common phenomena in patients with chronic HCV, this study hypothesized a relationship between IGF-1/ IGFBP-3 ratio and the degree of insulin resistance as well as the severity of hepatic steatosis in these patients.In this cross-sectional study, 85 patients with chronic HCV were included. The patients were grouped according to the degree of steatosis and the severity of liver cirrhosis/ fibrosis by histo-pathological examination of their liver biopsy. IGF-1 and IGFBP-3 were assessed in these patients the commercially-available kits. Insulin resistance was determined using HOMA-IR calculation.Serum level of IGF-1 was found to be decreased in proportion to the degree of the hepatic steatosis, while IGFBP-3 was not. So, IGF-1/ IGFBP-3 ratio was found to be declined in proportion to the degree of the hepatic steatosis. Also, IGF-1/ IGFBP-3 ratio was found to be inversely correlated with HOMA-IR. Serum zinc level was found to be significantly correlated with the level of IGF-1.Low level of circulating free IGF-1, which is derived from zinc deficiency, may be responsible for hepatic steatosis and insulin resistance in chronic HCV patients.