Introduction: Hepatitis C virus (HCV) genotype 4 is the most prevalent in Egypt.
Visceral adiposity index (VAI) and (TyG) index are newly developed indices for assessment
of metabolic syndrome (MS) and insulin resistance (IR). We aimed at
comparing their levels in HCV-patients with healthy controls and validate their use
for prediction of hepatic histopathological changes. Patient and Methods: 78 chronic
HCV-infected patients proven by PCR, viral genotyping and hepatic histopathology,
and 67 healthy controls were enrolled. Presence of MS, Homeostasis Model Assessment
for IR estimation (HOMA-IR), TyG index, and VAI were assessed. Results:
HOMA-IR, TyG and frequency of MS were significantly higher in patients’ group (p
< 0.0001 for each) in comparison to controls. In HCV patients, increased fasting blood
glucose (FBG) was the only strong predictor of severe hepatic necro-inflammation.
High FBG, older age, female sex, high AST, TyG, VAI, serum lipids abnormalities
and presence of MS were all associated with severe fibrosis on univariate regression
analysis. Only high AST, TyG, VAI and LDL were independent predictors of severe
fibrosis. A model using the 4 parameters showed a strong validity in predicting advanced
hepatic fibrosis (AUC 0.801; CI: 0.705 - 0.897, p < 0001). Female sex, high
BMI, VAI, LDL and TG values are all significantly associated with moderate/severe
steatosis on univariate analysis. Among them, high BMI and LDL are the strong predictors
(AUC 0.738; CI 0.625 - 0.851, p = 0.002). Conclusion: HCV genotype 4 is
significantly associated with MS and increased values of HOMA IR and TyG index.
TyG index and VAI are valuable simple indices that could predict the histopathological
changes in Egyptian CHC patients.