肝脏铁蓄积可能与慢性丙型肝炎患者的胰岛素抵抗有关。
Hepatic iron accumulation may be associated with insulin resistance in patients with chronic hepatitis C.
机构信息
Department of Gastroenterology and Hepatology, Nara City Hospital, Nara, Japan.
出版信息
Hepatol Res. 2007 Nov;37(11):932-40. doi: 10.1111/j.1872-034X.2007.00152.x.
BACKGROUND/AIM: Insulin resistance and hepatic iron overload are frequently demonstrated in hepatitis C virus (HCV)-related liver diseases. We investigated the relationship between insulin resistance and hepatic iron deposition in patients with chronic HCV infection.
METHODS
Insulin resistance was evaluated using the homeostasis model assessments for insulin resistance (HOMA-IR) in 56 non-diabetic non-obese patients with biopsy proven chronic hepatitis C. The relationship between insulin resistance and serum ferritin levels or the grade of hepatic iron deposition was assessed.
RESULTS
The levels of plasma immunoreactive insulin (IRI) and HOMA-IR were significantly correlated with serum ferritin levels and the grade of hepatic iron deposition (P = 0.003).Although IRI and HOMA-IR increased in parallel with the development of hepatic fibrosis, insulin resistance (HOMA-IR > 2) was observed in 11 (26.2%) of 42 patients even without severe fibrosis (F0-2). Among patients without severe fibrosis, IRI and HOMA-IR were significantly higher in patients with iron deposits than in those without iron deposits.
CONCLUSION
Hepatic iron overload may be associated with insulin resistance in patients with chronic hepatitis C, especially in patients with mild to moderate fibrosis.
背景/目的：丙型肝炎病毒（HCV）相关肝病常表现为胰岛素抵抗和肝铁过载。本研究旨在探讨慢性 HCV 感染患者胰岛素抵抗与肝铁沉积之间的关系。
方法
对 56 例经肝活检证实的非肥胖非糖尿病慢性丙型肝炎患者采用稳态模型评估的胰岛素抵抗指数（HOMA-IR）评估胰岛素抵抗。评估胰岛素抵抗与血清铁蛋白水平或肝铁沉积程度之间的关系。
结果
血浆免疫反应性胰岛素（IRI）和 HOMA-IR 水平与血清铁蛋白水平和肝铁沉积程度呈显著相关（P = 0.003）。尽管随着肝纤维化的发展，IRI 和 HOMA-IR 呈平行升高，但在 42 例无严重纤维化（F0-2）的患者中仍有 11 例（26.2%）存在胰岛素抵抗（HOMA-IR＞2）。在无严重纤维化的患者中，有铁沉积的患者的 IRI 和 HOMA-IR 明显高于无铁沉积的患者。
结论
慢性丙型肝炎患者的肝铁过载可能与胰岛素抵抗有关，尤其是在肝纤维化程度较轻至中度的患者中。
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