الفهرس 
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Abstract
The aim of this work was to study the level of
total cholesterol, HDLc, LDLc, total phosphalipids,
triglycerides, fasting and post-prandial insulin levels
in the serum of bilharzial hepatic fibrosis patients
with and without ascites, in a trial to correlate between
these changes and the clinical condition of these patients.
The study was performed on the following groups :
1- Pathological group :
Thirty patients with bilharzial hepatic fibrosis.
- Group I: Fifteen cases without ascites.
- Group II: Fifteen cases with ascites.
2- Control group :
Ten normal control subjects for comparison.
The patients were selected according to careful history,
clinical examination, liver function tests, ultra-sonography,
rectal snip and finally confirmed by liver biQPsy.
All the selected patients and control subjects were
subj ected to the following investigation’ :
Total serum cholesterol, HDLc, LDLc, total phosphalipids,
triglycerides. fasting and post-prandial glucose
and insulin serum level.
The results obtained revealed that :
Total cholesterol, HDLc, LDLc, total phospholipids
and triglycerides levels were found to be lower than that of
normal control subjects and this decrease was statistically
significant.
The cholesterol 1 phosphalipids ratio was lower
than that of normal control but this decrease was statistically
insignificant.
These results explain and confirm the low incidence
of atherosclerosis, hypertension and myocardial infarction
in patients with bilharzial hepatic fibrosis.
The fasting gI.ucoselevel was found to be within
the range of normal control in both groups of patients
while the post-prandial level showed statistically significant
elevation in both groups but more in ascitic cases.
The fasting and post prandial insulin level showed
statistical significant elevation in both groups of patients
compared to the normal control group and more in ascitic
group than the non-ascitic one.
This high level of insulin in serum of patients with
bilharzial hepatic fibrosis would not only explained by the
impaired trapping and degradation by the impaired hepatic
cells but also there would be insulin resistance which
explain the presence of post-prandial hyperglycaemia inspite
of this high level of insulin, also this explain the glucose
intolerance in bilharzial hepatic fibrosis patients.