Wisniewska-Ligier Malgorzata, Wozniakowska-Gesicka Teresa, Kups Joanna, Sulat-Syncerek Dorota
III Department of Pediatrics, Polish Mother's Hospital, Research Institute, Lodz, Poland.
Hepatogastroenterology. 2006 Nov-Dec;53(72):887-91.
BACKGROUND/AIMS: The importance of lipid metabolism in the pathogenesis of chronic hepatitis C has been recognized in recent years. Bearing in mind remote sequelae of chronic hepatitis C in children, it seems reasonable to seek to determine potential risk factors for the development of cirrhosis and carcinogenesis. The aim of the study was to assess lipid metabolism in children with chronic HCV-related hepatitis.
The study comprised 16 children with chronic hepatitis C and 16 healthy controls. In all the children anthropometric data and after, overnight fasting, serum levels of total bilirubin, AST, ALT, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were investigated. In the study group biopsy specimens were assessed.
Macrovesicular steatosis in numerous hepatocytes was found in 3 children. Total cholesterol level in children with chronic hepatitis was significantly lower than in control group (p < or = 0.05). Mean values of body mass, height, body mass index (BMI), levels of bilirubin, HDL-cholesterol, LDL-cholesterol, triglycerides and HDL/C index did not differ significantly between the two groups. No correlation between lipid parameters and histological markers, hepatic enzymes, patient age, weight, height or BMI was found.
Neither obesity nor hyperlipidemia, which are recognized risk factors for steatosis were found in children with HCV-related hepatitis. Lower cholesterol levels in children with chronic HCV infection compared to the controls and only scarce signs of steatosis which were noted could suggest the risk, existing already in such young patients, of developing fatty liver disease with its consequences including cirrhosis and neoplastic disease.
背景/目的：近年来，脂质代谢在慢性丙型肝炎发病机制中的重要性已得到认可。考虑到儿童慢性丙型肝炎的远期后遗症，探寻肝硬化和癌变发生的潜在危险因素似乎是合理的。本研究的目的是评估慢性丙型肝炎病毒（HCV）相关肝炎患儿的脂质代谢情况。
本研究纳入了16例慢性丙型肝炎患儿和16例健康对照。对所有儿童进行人体测量数据采集，并在过夜禁食后检测血清总胆红素、谷草转氨酶（AST）、谷丙转氨酶（ALT）、总胆固醇、低密度脂蛋白胆固醇（LDL-胆固醇）、高密度脂蛋白胆固醇（HDL-胆固醇）和甘油三酯水平。对研究组患儿进行肝活检标本评估。
3例患儿的大量肝细胞出现大泡性脂肪变性。慢性肝炎患儿的总胆固醇水平显著低于对照组（p≤0.05）。两组间的体重、身高、体重指数（BMI）、胆红素水平、HDL-胆固醇、LDL-胆固醇、甘油三酯水平和HDL/C指数的平均值无显著差异。未发现脂质参数与组织学指标、肝酶、患儿年龄、体重、身高或BMI之间存在相关性。
在HCV相关肝炎患儿中未发现肥胖或高脂血症这些公认的脂肪变性危险因素。与对照组相比，慢性HCV感染患儿的胆固醇水平较低，且仅观察到少量脂肪变性迹象，这可能提示这类年轻患者已存在发生脂肪性肝病及其后果（包括肝硬化和肿瘤性疾病）的风险。
