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瘦素是否为慢性乙型肝炎治疗反应终点的预测因素?

Is leptin a predictive factor in the end of therapy response in chronic hepatitis B?

作者信息

Selimoglu Mukadder Ayşe, Ertekin Vildan

机构信息

Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Faculty of Medicine, Atatürk University, Erzurum, Turkey.

出版信息

Pediatr Int. 2005 Aug;47(4):378-81. doi: 10.1111/j.1442-200x.2005.02083.x.

Abstract

BACKGROUND

The purpose of this study was to determine the leptin levels in children with chronic hepatitis B virus (HBV) infection, and to evaluate the effect of serum leptin levels on the end of therapy response (ETR). It is known that leptin stimulates T-cell immunity and so T-cell mediated immune response is critical in the outcome of chronic HBV infection.

METHODS

Leptin levels in children with chronic HBV infection were investigated and its effects on the ETR in 24 children who were treated with interferon-alpha and lamivudine combination therapy were evaluated.

RESULTS

The mean leptin level of the patients was higher than that of healthy children (P = 0.034). Of the patients, seven (29.2%) had ETR. The mean hepatic activity index and portal inflammation score were higher, the HBV DNA was lower, and the leptin level was similar in children with ETR when compared to others (P = 0.017, P = 0.04, P = 0.007, P = 0.34, respectively). HBV DNA and the fibrosis score were positively correlated (P = 0.016).

CONCLUSION

Although the higher leptin value observed in children with ETR was not statistically significant, because of close interactions between leptin, cytokines and lymphocytes, it is thought that leptin should be investigated as a predictive factor of ETR in further studies.

摘要

背景

本研究旨在测定慢性乙型肝炎病毒(HBV)感染儿童的瘦素水平,并评估血清瘦素水平对治疗结束反应(ETR)的影响。已知瘦素可刺激T细胞免疫,因此T细胞介导的免疫反应在慢性HBV感染的转归中至关重要。

方法

对慢性HBV感染儿童的瘦素水平进行了研究,并评估了其对24例接受α干扰素和拉米夫定联合治疗儿童的ETR的影响。

结果

患者的平均瘦素水平高于健康儿童(P = 0.034)。患者中,7例(29.2%)有ETR。与其他儿童相比,有ETR的儿童平均肝活动指数和门静脉炎症评分更高,HBV DNA更低,瘦素水平相似(分别为P = 0.017, P = 0.04, P = 0.007, P = 0.34)。HBV DNA与纤维化评分呈正相关(P = 0.016)。

结论

尽管在有ETR的儿童中观察到的较高瘦素值无统计学意义,但由于瘦素、细胞因子和淋巴细胞之间存在密切相互作用,因此认为在进一步研究中应将瘦素作为ETR的预测因素进行研究。

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