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Abdel-Raziq, F., Berengy, M., Mohammed, A., Emran, T. (2018). Relationship between Type 2 Diabetes Mellitus and the occurrence of Gastroesophageal varices in patients with chronic Hepatitis C Virus Related Liver Cirrhosis. The Egyptian Journal of Hospital Medicine, 73(8), 7196-7203. doi: 10.21608/ejhm.2018.17787
Fathy G. Abdel-Raziq; Mahmoud S. Berengy; Ahmed RA Mohammed; Tarek M. Emran. "Relationship between Type 2 Diabetes Mellitus and the occurrence of Gastroesophageal varices in patients with chronic Hepatitis C Virus Related Liver Cirrhosis". The Egyptian Journal of Hospital Medicine, 73, 8, 2018, 7196-7203. doi: 10.21608/ejhm.2018.17787
Abdel-Raziq, F., Berengy, M., Mohammed, A., Emran, T. (2018). 'Relationship between Type 2 Diabetes Mellitus and the occurrence of Gastroesophageal varices in patients with chronic Hepatitis C Virus Related Liver Cirrhosis', The Egyptian Journal of Hospital Medicine, 73(8), pp. 7196-7203. doi: 10.21608/ejhm.2018.17787
Abdel-Raziq, F., Berengy, M., Mohammed, A., Emran, T. Relationship between Type 2 Diabetes Mellitus and the occurrence of Gastroesophageal varices in patients with chronic Hepatitis C Virus Related Liver Cirrhosis. The Egyptian Journal of Hospital Medicine, 2018; 73(8): 7196-7203. doi: 10.21608/ejhm.2018.17787

Relationship between Type 2 Diabetes Mellitus and the occurrence of Gastroesophageal varices in patients with chronic Hepatitis C Virus Related Liver Cirrhosis

Article 1, Volume 73, Issue 8, October 2018, Page 7196-7203  XML PDF (378.29 K)
Document Type: Original Article
DOI: 10.21608/ejhm.2018.17787
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Authors
Fathy G. Abdel-Raziq1; Mahmoud S. Berengy1; Ahmed RA Mohammed1; Tarek M. Emran2
1Internal Medicine Department, Faculty of Medicine, Al-Azhar University (Damietta)
2Clinical Pathology Department, Faculty of Medicine, Al-Azhar University (Damietta)
Abstract
Background: Hepatitis C virus (HCV) infection is a challenging health problem in Egypt. Esophageal varices are a major complication of it which may bleed and endanger patient's life.
Aim of the work: to assess the relationship between type-2 DM and the development of gastroesophageal varices and explore the role of insulin resistance as a predictor of gastroesophageal varices.
Patients and methods: This study included 100 patients with Child A, HCV-induced cirrhosis. They were divided into two main groups: Group A included 50 patients with type-2 DM, while Group B: included 50 non-diabetic which were subdivided into: Group B1: patients without DM but, with insulin resistance (IR) {32}, and Group B2: patients without DM or IR {18}. All patients were subjected to full history taking, clinical examination, laboratory and imaging studies (abdominal ultrasound) and upper GI endoscopy.
Results: The prevalence of esophageal varices in patients with Child A HCV-induced cirrhosis was 80%, elevated to 88% in patients with type-2 DM. Insulin resistance played the major role in development of esophageal varices. There are statistically significant elevated HOMA-IR score, lower platelet count/spleen diameter ratio and higher right liver lobe diameter/albumin ratio in patients with varices.
Conclusion: Insulin resistance is a major contributor for development of esophageal varices in HCV induced cirrhosis. Platelet count/spleen diameter ratio, right liver lobe diameter/albumin ratio and insulin resistance measured by HOMA-IR are good predictors for the presence of esophageal varices.
Keywords
Type-2 diabetes mellitus; Insulin Resistance; hepatitis C virus infection; gastroesophageal varices
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