الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
Summary
Hepatitis C is a major cause of liver related
morbidity and mortality worldwide and represents a major
public health problem, chronic hepatitis C virus (HCV)
infection has been associated with a number of extrahepatic
manifestations, one of these manifestations is insulin
resistance.
Hepatitis C virus appears to contribute, directly or
indirectly, to the development of IR .IR is not only a
precursor to diabetes, but also independently associated
with significant morbidity, including hypertension and
coronary heart disease. The presence of IR in the setting of
hepatitis C infection is of particular importance, because it
also plays a role in the progression of HCV-related liver
disease and may be associated with suboptimal responses to
antiviral therapy.
The main aim of this work is to find possible relation
between the occurrence of insulin resistance in hepatitis C
virus infected children who were either thalassemic or
survivors of childhood malignancy.
This cross-sectional case- control study conducted
on 60 hepatitis C virus infected children (30 patients were
thalassemic and 30 were survivors of childhood
malignancy) and 30 controls who were neither HCV
infected nor diabetics. They were recruited from Pediatric
hematology and oncology clinics, Children’s Hospital, Ain
Shams University.
Patients with the following conditions were excluded:
Concurrent active hepatitis B virus infection or
autoimmune hepatitis, primary biliary cirrhosis (PBC),
sclerosingcholangitis, haemochromatosis, α1-antitrypsin
deficiency or Wilson’s disease, patients with obesity (BMI
> 25) and type 2 DM.
All the included patients were subjected to:
1.Full Medical History
2.Complete Physical Examination
3.Laboratory Investigations:
CBC, Liver function tests (ALT, AST, Alkalin
phosphatase, Serum Bilirubin, PT and Serum albumin),
Fasting blood glucose, Fasting Insulin ,Serum ferritin,
HCV antibody, HCV-RNA(by PCR), Homeostasis
model assessment (HOMA) of insulin resistance.
In the present study there was positive correlation
between serum ferritin among all patients with Total
bilirubin, platelets, ALT and ALP, and There was negative
correlation between serum ferritin and HG.
There was positive correlation between fasting
insulin among all patients with weight and between fasting
insulin and HOMA. Also there was positive correlation
between HCV level by PCR and albumin.
There was statistically significant difference between
patients and controls as regard fasting glucose, fasting
insulin, HOMA and HOMA IR. There was no significant
difference as regard the previous items between the two
subgroups of patient involved in the study. HOMA IR was
found normal among all controls (100%) and in 48 patients
(80%), moderate HOMA IR was present in 12 patient
(20%) no severe HOMA IR was present in patients enrolled
in this study.