Resistin and Insulin Resistance: A Link Between Inflammation and Hepatocarcinogenesis

Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading causeof cancer related death overall. The role of insulin resistance in the development of HCC associated with chronicHCV infection has not been established. Resistin is a polypeptide hormone belonging to the adipokine family whichcould contribute to tumorigenesis and angiogenesis. Our aim was to study serum resistin and insulin resistanceas risk factors for HCC in HCV cirrhotic patients. Materials and
Methods: This prospective case controlledstudy included 100 patients with HCV related liver cirrhosis and HCC, 100 patients with HCV related livercirrhosis without HCC and 50 apparently healthy participants as controls. For all subjects, liver profile, serologicmarkers for viral hepatitis, lipid profile, alpha-fetoprotein level (AFP), homeostasis model assessment (HOMA)were examined along with resistin.
Results: HCC patients had higher mean values of HOMA-IR and resistinthan cirrhotic patients and the control subjects (p<0.01). HOMA and resistin were considered independent riskfactors in development of HCC, those patients with resistin › 12 ng/ml and HOMA ›4 being 1.6 times more likelyto have HCC.
Conclusions: HOMA and serum resistin allow for early identification of patients with cirrhosiswhoare at substantially increased risk of HCC. Recommendation: HOMA and serum resistin could represent novelmarkers to identify HCV cirrhotic patients at greater risk of development of HCC.