Title:Predicting Esophageal Varices in Cirrhotic Hepatitis C Virus Patients Using Noninvasive Measurement of Insulin Resistance Variables
Volume: 18
Issue: 6
Author(s): Elsaid Wasfy, Galal Elkassas, Sally Elnawasany, Kariman Elkasrawy, Sherief Abd-Elsalam*, Shaimaa Soliman and Rehab Badawi
Affiliation:
- Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Tanta,Egypt
Keywords:
Insulin resistance, esophageal varices, HOMA-IR score, non-invasive, cirrhotic hepatitis C virus, portal hypertension.
Abstract: Background& Aims: Esophageal varices (EV) are a major complication of portal hypertension
in cirrhotic patients. Screening is essential for all patients with cirrhosis. Performing non-invasive
methods for screening is a cost-effective and time-saving measure. The aim of this work is to evaluate
whether insulin resistance (IR) assessed by HOMA-IR score can predict the presence of EV or not.
Methods: This cross-sectional study was carried out on sixty Egyptian cirrhotic HCV patients divided
into 3 groups: Group I: 20 cirrhotic patients without esophageal varices, Group II: 20 cirrhotic patients,
with small esophageal varices and Group III: 20 cirrhotic patients with large esophageal
varices. Fasting insulin level was measured and HOMA- IR score was calculated. Abdominal ultrasound
and Fibroscan were done to all patients.
Results: Insulin resistance assessed by HOMA –IR score showed a statistically significant difference
among the three groups (P<0.001) with a cutoff value equal to or more than 3.40. It could significantly
predict EV (AUROC= 0.841) with high sensitivity of 75 %, and excellent specificity 80%. Liver stiffness
measurement (LSM) with a cutoff value 40.95 kPa could significantly predict EV (AUROC=
0.629) with sensitivity 75 %, specificity 50 %.
Conclusion: HOMA-IR score is a new independent predictor of the presence of EV.
