Selenium deficiency is associated with insulin resistance in patients with
hepatitis C virus – related chronic disease
Himoto, Yoneyama H, Kurokohchi K, Inukai M, Masugata H, Goda F, et al. Nutrition Research. 2011: (31):829-835.
Presenters: Kate Ueland and DeeAnna VanReken
Background Hepatitis C virus
Infected person may carry many variants – quasi-species which have high multiplicity rate
Incubation period of 2-26 weeks Asymptomatic in 75% of cases Cirrhosis develops in 20% of cases
Statistics A major cause of liver disease Worldwide carrier rate is est. at 175 million
people Most frequently requires liver transplant in
U.S. No vaccine is currently available
BackgroundWhat is the role of Selenium (Se)?
Essential constituent of selenoproteins Notably glutathione peroxidase (GPx)
Previous studies have shown that serum Se levels frequently decline in pts with type 2 diabetes mellitus (T2DM)
Author’s Hypothesis
Serum Se levels decline in proportion to the severity of hepatic fibrosis in patients with
Hepatitis C virus-related chronic liver disease (HCV-CLD), and the decrease in Se
levels contribute to insulin resistance in those patients.
Methods Study population
Experimental group: 52 non-diabetic patients with HCV-RNA in sera along with histological signs ranging from chronic hepatitis to liver cirrhosis.
Control group: 11 normal healthy patients/no Se supplementation
Assays Glutathione Peroxidase levels in sera ELISA Insulin Resistance HOMA-IR
Methods Histological Assessments
Liver tissue stained with hematoxylin and eosin
Inuyama classification system F0 = no fibrosis in liver
F1 = fibrous portal expansion
F2 = bridging fibrosis
F3 = bridging fibrosis with lobular destruction
F4 = liver cirrhosis
Results
Himoto et al. Nutrition Research. 2011
Results
Himoto et al. Nutrition Research. 2011
Author’s conclusions Decrease in serum Se levels was associated with
severity of hepatic fibrosis in pts with HCV-CLD
An inverse correlation was found between serum Se concentration and insulin resistance
Insulin resistance was associated with severity of Se deficiency in pts with HCV-related CLD
Se deficiency may eventually facilitate oxidative stress in the liver of patients with HCV-CLD
Study Limitations
Efficacy of Se supplementation not confirmed Determine optimal dose of Se supplementation to
attenuate insulin resistance
Selenium deficiency not properly defined Mucosal abnormalities were suggested
Inadequate data to explain the link between insulin resistance and Se deficiency Insulin mimetic properties were suggested
Question for the audience
Selenium is an essential constituent in what antioxidant
enzyme?
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Himoto T, Yoneyama H, Kurokohchi K, Inukai M, Masugata H, Goda F, et al. Selenium deficiency is associated with insulin resistance in patients with hepatitis C virus-related chronic liver disease. Nutrition research. 2011: (31): 829-835.
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