P.04.4 SVR TO ANTIVIRAL TREATMENT FOR POST-OLT RECURRENT HCV HEPATITIS CAN BE IMPROVED BY THE USE OF GROWTH FACTORS

Background and aim: Although the lack of extensive data in humans, bile acids (BAs) and particularly CDCA a potent FXR and TGR5 ligand, are signaling molecules in glucose, lipid and energy metabolism. Aim of our study was to evaluate serum BA profile including Glycine (G), Taurine (T) and Unconjugated (U)-Bas in blood donors (BD) and to identify correlations between individual BA concentration in normal and insulin-resistant (IR) subjects. Material and methods:We prospectively enrolled 160 blood donors from our Transfusion Center, from January to June 2011. Exclusion criteria were: alteration in blood tests, history of liver or GI disease, previous abdominal surgery and treatment with metabolic and GI medications. All patients underwent biochemistry tests (fasting glucose and insulin, total cholesterol, HDL, LDL, triglycerides (TG), ALT, GammaGT, ALP) and serum BA profile measurement (HPLC-ESI-MS/MS). All patients underwent an abdominal ultrasound within a week from enrollment. Medical history, laboratory parameters and ultrasonographic findings of all subjects were reviewed from our physicians and subjects were classified as Healthy (H, n=120), IR (n=28) and gallstone subjects (GS, n=12, excluded from analysis). Results: 148 subjects (84 male/64 female; mean age 41.7±12.6) met the inclusion criteria. BMI was 25.1±3.7; total cholesterol 194.6±35.6; HDL 60.5±15.2; TG 91.8±48.7; ALT, GammaGt, ALP and other mean biochemical index were within normal limits. In IR subjects, total serum BAs (5.02±2.39 vs 3.56±2.55 μmol/l; P= 0.0017), serum unconjugated BAs (1.95±1.25 vs 1.40±1.17 μmol/l; P= 0.025) and CDCA (2.28±1.39 vs 1.63±1.43; P=0.03) were significantly higher than in healthy subjects. On multivariate analysis, BMI (r=0.35; P<0.0001), CDCA (r= 0.194; P= 0.0033) and TG (r=0.26; P=0.0134) were independently and directly related to the HOMA-IR. No significant correlation were found between serum cholesterol or triglycerides levels and serum BA profile. Conclusions: Total serum Bas (U-Bas, G-Bas, T-Bas) and particularly CDCA are significantly increased in patients with IR. CDCA, together with BMI and TG are independently related to insulin-resistance.