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丙型肝炎、代谢综合征与炎症标志物:第三次全国健康和营养检查调查(NHANES III)的结果

Hepatitis C, metabolic syndrome, and inflammatory markers: results from the Third National Health and Nutrition Examination Survey [NHANES III].

作者信息

Shaheen Magda, Echeverry Diana, Oblad Marcela Garcia, Montoya Marie I, Teklehaimanot Senait, Akhtar Abbasi J

机构信息

Department of Internal Medicine, Charles R. Drew University of Medicine and Science, 12021 South Wilmington Avenue Los Angeles, CA 90059, United States.

出版信息

Diabetes Res Clin Pract. 2007 Mar;75(3):320-6. doi: 10.1016/j.diabres.2006.07.008. Epub 2006 Aug 17.

Abstract

Studies have shown that hepatitis C (HCV) is associated with type 2 diabetes mellitus (DM2) possibly due to insulin resistance and inflammation. Metabolic syndrome is a risk factor for DM2. Our objectives were to assess the relationship between HCV and metabolic syndrome and inflammatory markers. We used data from The Third National Health Nutrition and Examination Survey (NHANES-III). We excluded pregnant women, subjects with diabetes, those taking non-steroidal anti-inflammatory drugs, and those diagnosed with concomitant infection. We analyzed the data controlling for demographic variables, body mass index, use of contraceptives, had arthritis, and had gout. Among the 10,383 subjects, 2.3% had HCV and 16.7% had metabolic syndrome using the ATP III criteria. After controlling for the confounders, HCV was not associated with metabolic syndrome but associated with HOMA insulin resistance and inflammatory marker ferritin. Among subjects with both HCV and metabolic syndrome, the adjusted HOMA insulin level was higher than those without HCV and metabolic syndrome. In addition, the serum ferritin level was a strong predictor of HOMA insulin resistance. In clinical practice, serum ferritin can be obtained along with routine blood tests in any laboratory, and it has a potential to be a surrogate marker of insulin resistance in people with HCV and metabolic syndrome.

摘要

研究表明,丙型肝炎(HCV)与2型糖尿病(DM2)相关,可能是由于胰岛素抵抗和炎症。代谢综合征是DM2的一个危险因素。我们的目标是评估HCV与代谢综合征及炎症标志物之间的关系。我们使用了第三次全国健康与营养检查调查(NHANES-III)的数据。我们排除了孕妇、糖尿病患者、服用非甾体抗炎药的人以及被诊断为合并感染的人。我们在控制了人口统计学变量、体重指数、避孕药使用情况、患有关节炎和痛风的情况下分析了数据。在10383名受试者中,根据ATP III标准,2.3%患有HCV,16.7%患有代谢综合征。在控制了混杂因素后,HCV与代谢综合征无关,但与HOMA胰岛素抵抗和炎症标志物铁蛋白有关。在同时患有HCV和代谢综合征的受试者中,调整后的HOMA胰岛素水平高于没有HCV和代谢综合征的受试者。此外,血清铁蛋白水平是HOMA胰岛素抵抗的一个强预测指标。在临床实践中,血清铁蛋白可以在任何实验室与常规血液检查一起获得,并且它有可能成为HCV和代谢综合征患者胰岛素抵抗的替代标志物。

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