Insulin Resistance, Metabolic Syndrome and Hepatic Fibrosis and Their Association with Vaspin and Fibronectin in Chronic Hepatitis C

Presentation Number: MON 620
Date of Presentation: April 3rd, 2017

Mohan T Shenoy*1, Harish Kumar2, Harikumar R Nair3, Praveen V P2, Nisha Bhavani4, Arun S Menon5, Usha V Menon5, RV Jayakumar5, Vasantha Nair5, Nithya Abraham6 and Shine Sadasivan7
1Sree Gokulam Medical college and research foundation, Venjaramoodu, Trivandrum, Kerala, Kochi, INDIA, 2Amrita Institute of Medical Sciences, Kochi, Kochi, India, 3QUEEN ALEXANDRA HOSPITAL, PORTSMOUTH HOSPITALS NHS TRUST,PO6 3LY,UK., United Kingdom, 4Amrita Institute of Medical Sciences, Kochi, Cochin, INDIA, 5Amrita Institute of Medical Sciences, Cochin, India, 6Amrita Institute of Medical Sciences, Kochi, 7Amrita Institute of Medical Sciences, Kochi, India

Abstract

Objective: To study the prevalence of metabolic syndrome (MS), Insulin resistance (IR) and their association with adipocytokines namely Vaspin and Fibronectin and hepatic fibrosis in chronic HCV infection.

Design: Cross sectional study.

Methods: We evaluated the anthropometry, metabolic profile, visceral adiposity index (VAI), fasting glucose, lipid profile, insulin and HOMA IR. Serum assays of vaspin, fibronectin, HCV RNA viral load (IU/ml), genotype, hepatic histopathology (modified Ishak knodell HAI scoring, Metavir and SAF staging) were perfomed.

Data was analysed by SPSS version 20 windows using univariate and multivariate regression for the association of IR, MS with vaspin, fibronectin, and liver fibrosis.

Results: 32 subjects (male 18; females 14) of 28 to 64 years range were included. Their BMI ranged 17.79 to 39.4 and HbA1c ranged from 4.5 to 10.9 %. MS was seen in 13 subjects (41%). IR was abnormal in 14 - moderate in 4 and severe in 10. Genotypes 3, 1 and 4 were 18; 11 and 3 respectively. With a 0.08 ng/ml cut-off, Vaspin had 71.4% sensitivity, 72.2% specificity; 66.7% positive predictive value and 76.4% negative predictive value. Higher vaspin was associated with MS (odds ratio (OR) 9.3); and with abnormal IR (OR 6.5:; p value 0.014) and with fibrosis (OR 5: p value 0.066). High fibronectin level was not associated with fibrosis. There was no correlation of visceral adiposity index with vaspin or fibronectin.

Conclusion: Vaspin had significant association with metabolic syndrome, IR and hepatic fibrosis. Fibronectin is of no utility in assessing fibrosis.

 

Nothing to Disclose: MTS, HK, HRN, PVP, NB, ASM, UVM, RJ, VN, NA, SS