Huang Jee-Fu, Dai Chia-Yen, Yu Ming-Lung, Shin Shyi-Jang, Hsieh Ming-Yen, Huang Chung-Feng, Lee Li-Po, Lin Kun-Der, Lin Zu-Yau, Chen Shinn-Chern, Hsieh Ming-Yuh, Wang Liang-Yen, Chang Wen-Yu, Chuang Wan-Long
Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
J Hepatol. 2009 Mar;50(3):471-8. doi: 10.1016/j.jhep.2008.10.023. Epub 2008 Dec 25.
BACKGROUND/AIMS: Hepatitis C virus (HCV) infection carries a significant risk for development of insulin resistance (IR) and/or diabetes mellitus. Recently, retinol-binding protein 4 (RBP4) has been reported as a protein contributing to IR. This study aimed to assess the correlation between RBP4 and disease severity of chronic HCV infection (CHC).
Serum RBP4 was measured in 105 treatment-nai ve CHC patients and its correlation with the homeostasis model assessment of insulin resistance index (HOMA-IR), liver histology, virology and metabolic factors was investigated. Patients were stratified into different stages of glucose tolerance by oral glucose tolerance test.
There was a significant decreasing linear trend of RBP4 dependent on both histological grading (from 35.8+/-16.5 microg/mL of minimal to 19.2+/-12.5 microg/mL of severe, P=0.002) and staging (from 34.2+/-10.0 microg/mL of F0 to 22.2+/-11.9 microg/mL of F3-4, P=0.02) progression, whilst a significant increment of HOMA-IR was found. Multivariate regression analysis showed BMI (1.1, 95% CI 0.44 ~ 1.77, P=0.001), HDL-C (-0.40, 95% CI -0.73 ~ -0.06, P=0.02), and LDL-C (0.31, 95% CI 0.02 ~ 0.61, P=0.04) were the significant variables for prediction of RBP4.
Disease severity may limit the role of RBP4 as a predictor of IR in CHC.
背景/目的：丙型肝炎病毒（HCV）感染会显著增加胰岛素抵抗（IR）和/或糖尿病的发病风险。最近，视黄醇结合蛋白4（RBP4）被报道为一种与IR相关的蛋白。本研究旨在评估RBP4与慢性HCV感染（CHC）疾病严重程度之间的相关性。
检测了105例未经治疗的CHC患者的血清RBP4，并研究其与胰岛素抵抗指数稳态模型评估（HOMA-IR）、肝脏组织学、病毒学及代谢因素的相关性。通过口服葡萄糖耐量试验将患者分为不同的糖耐量阶段。
RBP4随组织学分级（从轻度的35.8±16.5μg/mL降至重度的19.2±12.5μg/mL，P=0.002）和分期（从F0期的34.2±10.0μg/mL降至F3-4期的22.2±11.9μg/mL，P=0.02）进展呈显著下降的线性趋势，同时HOMA-IR显著升高。多因素回归分析显示，体重指数（BMI）（1.1，95%可信区间0.441.77，P=0.001）、高密度脂蛋白胆固醇（HDL-C）（-0.40，95%可信区间-0.73-0.06，P=0.02）和低密度脂蛋白胆固醇（LDL-C）（0.31，95%可信区间0.02~0.61，P=0.04）是预测RBP4的显著变量。
疾病严重程度可能会限制RBP4作为CHC中IR预测指标的作用。
