Liu Chun-Jen, Chen Pei-Jer, Jeng Yung-Ming, Huang Wen-Ling, Yang Wei-Shiung, Lai Ming-Yang, Kao Jia-Horng, Chen Ding-Shinn
Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
J Hepatol. 2005 Aug;43(2):235-42. doi: 10.1016/j.jhep.2005.02.044.
BACKGROUND/AIMS: Adiponectin induces insulin sensitivity and modulates inflammatory responses. We thus studied the implications of adiponectin in patients with chronic hepatitis C virus (HCV) infection inherently linked to insulin resistance.
We analyzed the association of serum adiponectin levels with clinical, virologic, and histologic findings in 95 naive Taiwanese patients with chronic hepatitis C before and after antiviral therapy.
At baseline, 14 (15%) of the 95 patients were obese and 26 (27%) had type 2 diabetes mellitus. Fifty-seven patients were infected with HCV genotype 1 and 38 with genotype 2. Steatosis and periportal fibrosis was present in 44 (46%) and 69 (73%), respectively. In multivariate analysis, male gender, insulin resistance, high HCV load and genotype 2 were significantly associated with a lower serum adiponectin level. In contrast, intrahepatic gene expression of adiponectin receptors was higher in genotype 2 compared with genotype 1. Serum adiponectin level did not correlate with other clinical or histologic parameters. After treatment, change of steatosis also did not correlate with the change of adiponectin level (P=0.61).
Adiponectin correlated with hepatitis C viral factors at both serum and liver tissue levels. The interactions among adiponectin, insulin resistance and chronic HCV infection merit further studies.
背景/目的:脂联素可诱导胰岛素敏感性并调节炎症反应。因此,我们研究了脂联素在与胰岛素抵抗内在相关的慢性丙型肝炎病毒(HCV)感染患者中的意义。
我们分析了95例未经治疗的台湾慢性丙型肝炎初治患者在抗病毒治疗前后血清脂联素水平与临床、病毒学和组织学结果之间的关联。
基线时,95例患者中有14例(15%)肥胖,26例(27%)患有2型糖尿病。57例患者感染HCV基因1型,38例感染基因2型。分别有44例(46%)和69例(73%)存在脂肪变性和汇管区纤维化。多因素分析显示,男性、胰岛素抵抗、高HCV载量和基因2型与较低的血清脂联素水平显著相关。相比之下,基因2型患者肝内脂联素受体的基因表达高于基因1型。血清脂联素水平与其他临床或组织学参数无关。治疗后,脂肪变性的变化也与脂联素水平的变化无关(P=0.61)。
脂联素在血清和肝组织水平均与丙型肝炎病毒因素相关。脂联素、胰岛素抵抗和慢性HCV感染之间的相互作用值得进一步研究。