The Role of Insulin Resistance in the Prediction of Esophageal Varices in Cirrhotic non-Diabetic patients

Abstract

Background : Esophageal Varices (EV) caused by liver cirrhosis is a very common complication where endoscopy is the best screening procedure. Insulin resistance (IR) is a reliable predictor of portal hypertension. Aim of the work : This study aims to compare and evaluate the role of markers of IR and other non-invasive markers in the detection of EVs in patients with liver cirrhosis. Patients and methods : Fifty patients were screened in this cross-sectional study in the gastroenterology unit of the internal medicine department by abdominal ultrasound. ELISA technique was used to estimate fating serum insulin levels. Furthermore, (HOMA-IR) referring to the Homeostasis model assessment of IR was carried out. Results : Cirrhotic patients whether they possessed any grade of EV or not correlated with higher IR with their platelet count/spleen diameter ratio (PC/SD) and spleen diameter showing a statistically signi fi cant difference among the groups. Conclusion : Elevations in IR (as they were assessed by HOMA-IR) were found to be good predictors of the development of EVs noninvasively. The diameter of the Portal vein (PV), the diameter of the spleen, and PC/SD were also found to be good predictors of EVs.