179856 tn?1333547362

Higher HCC risk with increased insulin resistance

Just FYI - if you have IR you might want to also keep on top of this one too.

Better safe than sorry....I don't want to be the harbinger of doom but I know IR is a problem for some folks around here. I hate HCC if you can't tell.....no more of my friends should die of this.


Higher HCC risk with increased insulin resistance in hepatitis C patients
May 12, 2010

Recent studies have demonstrated that type 2 diabetes mellitus (DM) is associated with high risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C. Insulin resistance (IR), which correlates inversely with circulating adiponectin concentration, is a consistent finding in patients with type 2 DM. Chronic hepatitis C virus (HCV) infection has been reported to be associated with increased IR. Recent studies suggest that IR plays a crucial role in fibrosis progression, and has been demonstrated to have a negative impact on treatment responses to antiviral therapy in patients with chronic hepatitis C.

A research article to be published on May 14, 2010 in the World Journal of Gastroenterology addresses this question. The research team led by Dr. Hung from Kaohsiung Chang Gung Memorial Hospital prospectively investigated the IR assessed by the homeostasis model (HOMA-IR) and serum adiponectin level in two independent cohorts of consecutive newly diagnosed HCC patients and those with different clinical stages of chronic HCV infection.

Among 165 HCC patients, type 2 DM was more prevalent in HCV subjects compared to hepatitis B virus (HBV) or non-HBV, non-HCV cases. HOMA-IR was higher in HCC patients with HCV than in those with HBV infection. In 188 patients with chronic hepatitis C, HCC subjects had higher blood sugar, insulin level and HOMA-IR than those with chronic hepatitis and advanced fibrosis.

Based on stepwise logistic regression analysis, HOMA-IR was one of the independent factors associated with HCC development. This result was similar even if the diabetic subjects were excluded for analysis. The research team concluded that increased IR, regardless of the presence of diabetes, is significantly associated with HCC development in patients with chronic HCV infection.

These findings may have important prognostic and therapeutic implications in the management of chronic HCV-infected patients. Since IR is a potentially modifiable factor, therapeutic intervention aimed at decreasing IR may be warranted in these patients.

More information: Hung CH, Wang JH, Hu TH, Chen CH, Chang KC, Yen YH, Kuo YH, Tsai MC, Lu SN, Lee CM. Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection. World J Gastroenterol 2010; 16(18): 2265-2271 http://www.wjgnet.com/1007-9327/full/v16/i18/2265.htm

Provided by World Journal of Gastroenterology (news : web)

34 Responses
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568322 tn?1370165440
CS created a HOMA calculator.  I'll send it to you.

Is 25 cents a fair price?  LOL  Want me to add it to your bill?

Helpful - 0
Avatar universal
sure - put it on my tab. I'll add it to my collection of dubious bioinformatic software...

But seriously, doesn't the discrepancy seem a bit weird? This isn't just rounding error.  By one measure bandman's numbers indicate serious IR, by the other (newer) index he's very close to in-range. Which is telling the truth?
Helpful - 0
Avatar universal
Here are my test results.  My Glucose is 88 mg/dL.  My Insulin result is 9.4 uIU/mL.  According to my calculations my HOMA-IR score is 2.04.  I think I'm okay.  

Helpful - 0
Avatar universal
From what I've heard, a score less than 2 is good, and a score greater than 2 indicates Insulin Resistance.  Looks like that's where I'm headed if I don't do something about it.  Good thing I got this checked out.  
Helpful - 0
Avatar universal
the HOMA2 score for 88 mg/dL and 9.4 uU/ml is 1.2. (you can get the calculator for Matthew's revised index at the Oxford university link above to check).  Ranges for HOMA1, HOMA2, scores generally seem to consider lt 2 OK. Here's a Stanford paper that reports insulin/glucose/HOMA values for 490, healthy, non-diabetics. (free-access)

From Table 1, avg fasting insulin was 12 and average HOMA-IR 2.7 .

Overall,  doesn't look like IR is an issue for you.  
Helpful - 0
338734 tn?1377160168
Great information. I was concerned about this during TX as my blood glucose was often a little elevated. Post TP I had to take insulin but glucose returned to normal whan I got off the steroids.

After TX, and subsequent relapse, I got an insulin test and computed HOMA score as 2.8. The problem is that I could not find any references to what this meant. What is too high, what is too low, etc.

I hope the info here will shed a little more light for me. I really think I am IR and suspect it could have been a factor in my relapse.
Helpful - 0
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