AIM:To elucidate the role of insulin resistance(IR) and serum adiponectin level in hepatocellular carcinoma(HCC) associated with chronic hepatitis C.METHODS:Clinical and biochemical characteristics were collected from 165 consecutive patients with newly diagnosed HCC.Homeostasis model assessment of IR(HOMA-IR) and serum adiponectin level were investigated in 188 patients with different stages of hepatitis C virus(HCV) infection.RESULTS:Among HCC patients,type 2 diabetics(DM) was more prevalent in HCV subjects(35.6%,n = 59) compared to hepatitis B virus(HBV;12.7%,n = 63) or non-HBV,non-HCV cases(7.1%,n = 28).In patients with chronic hepatitis C,HCC subjects had higher blood sugar(P < 0.001),insulin level(P = 0.003) and HOMAIR(P = 0.018) than those with chronic hepatitis and advanced fibrosis.Age,male sex and body mass index were significantly associated with serum adiponectin level,whereas HOMA-IR was not.Based on stepwise logistic regression analysis,age(OR:1.124,P < 0.001),serum insulin level(OR:1.585,P < 0.001),HOMA-IR(OR:0.495,P = 0.001),DM(OR:11.601,P = 0.002) and male sex(OR:3.877,P = 0.016) were independently associated with HCC.This result was similar even if the diabetic subjects were excluded for analysis.CONCLUSION:Insulin resistance measured by HOMAIR,regardless of the presence of diabetes,is significantly associated with HCC development in patients with chronic HCV infection. AIM: To elucidate the role of insulin resistance (IR) and serum adiponectin level in hepatocellular carcinoma (HCC) associated with chronic hepatitis C. METHODS: Clinical and biochemical characteristics were collected from 165 consecutive patients with newly diagnosed HCC. Homeostasis model assessment of IR (HOMA-IR) and serum adiponectin levels were investigated in 188 patients with different stages of hepatitis C virus (HCV) infection .RESULTS: Among HCC patients, type 2 diabetics (DM) was more prevalent in HCV subjects (35.6% 59 patients were more hepatitis B virus (HBV; 12.7%, n = 63) or non-HBV, non-HCV cases (7.1%, n = 28) <0.001), insulin level (P = 0.003) and HOMAIR (P = 0.018) than those with chronic hepatitis and advanced fibrosis. Age, male sex and body mass index were significantly associated with serum adiponectin level, whereas HOMA-IR was not. Based on stepwise logistic regression analysis, age (OR: 1.124, P <0.001), serum insul HOMA-IR (OR: 0.495, P = 0.001), DM (OR: 11.601, P = 0.002) and male sex with HCC.This result was similar even if the diabetic subjects were excluded for analysis. CONCLUSION: Insulin resistance measured by HOMAIR, regardless of the presence of diabetes, is significantly associated with HCC development in patients with chronic HCV infection.