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慢性丙型肝炎基因4型患者血清脂联素与脂肪变性的关系

The relationship between serum adiponectin and steatosis in patients with chronic hepatitis C genotype-4.

作者信息

Ashour Esmat, Samy Nervana, Sayed Magda, Imam Azza

机构信息

Biochemistry Department, National Research Center, Cairo, Egypt.

出版信息

Clin Lab. 2010;56(3-4):103-10.

Abstract

BACKGROUND

The mechanisms underlying steatosis during hepatitis C virus (HCV) infection are complex and multifactorial. The aim of our study was to assess whether host metabolic factors influence the degree of hepatic steatosis and fibrosis in patients infected with hepatitis C virus genotype 4 by investigating the role of adiponectin, leptin and insulin resistance.

METHODS

Adiponectin and leptin levels, HCV genotypes, HCV-RNA, IR (HOMA-IR), body mass index and liver steatosis and fibrosis were assessed in 74 chronic patients with HCV genotype 4.

RESULTS

Chronic HCV patients with steatosis showed lower serum adiponectin levels and higher levels of leptin, HOMA, alanine aminotransferase, gamma-glutamiltransferase and fibrosis scores. Low adiponectin levels were independently associated with grades of steatosis and HOMA-IR. Adiponectin levels showed significant inverse correlation between adiponectin and steatosis grade, BMI, HOMA and fibrosis stage. The multivariate analysis of factors showed that steatosis was significantly associated with low adiponectin concentration while leptin, insulin, HOMA, ALT, gamma-GT and cholesterol were positively associated with steatosis.

CONCLUSIONS

This study stated that patients with HCV genotype-4 suffering from steatosis had a lower adiponectin level which is inversely correlated with insulin resistance. These data support a role for adiponectin in protecting against liver injury and also that hypoadiponectinaemia may contribute to the progression of hepatic steatosis. Further molecular and genetic studies with larger numbers of patients are required to confirm these results.

摘要

背景

丙型肝炎病毒(HCV)感染期间脂肪变性的潜在机制复杂且多因素。我们研究的目的是通过研究脂联素、瘦素和胰岛素抵抗的作用,评估宿主代谢因素是否影响丙型肝炎病毒4型感染患者的肝脂肪变性和纤维化程度。

方法

对74例慢性丙型肝炎病毒4型患者评估脂联素和瘦素水平、HCV基因型、HCV-RNA、胰岛素抵抗(HOMA-IR)、体重指数以及肝脏脂肪变性和纤维化情况。

结果

伴有脂肪变性的慢性丙型肝炎患者血清脂联素水平较低,而瘦素、HOMA、丙氨酸转氨酶、γ-谷氨酰转移酶水平及纤维化评分较高。低脂联素水平与脂肪变性分级和HOMA-IR独立相关。脂联素水平与脂肪变性分级、BMI、HOMA及纤维化分期之间呈显著负相关。多因素分析显示,脂肪变性与低脂联素浓度显著相关,而瘦素、胰岛素、HOMA、ALT、γ-GT和胆固醇与脂肪变性呈正相关。

结论

本研究表明,丙型肝炎病毒4型且伴有脂肪变性的患者脂联素水平较低,且与胰岛素抵抗呈负相关。这些数据支持脂联素在预防肝损伤中的作用,也表明低脂联素血症可能促进肝脂肪变性的进展。需要更多患者进行进一步的分子和遗传学研究以证实这些结果。

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