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[慢性丙型肝炎患者的代谢综合征与胰岛素抵抗]

[Metabolic syndrome and insulin resistance in patients with chronic hepatitis C].

作者信息

Baĭzhanova Zh Zh, Ignatova T M, Nekrasova T P

出版信息

Ter Arkh. 2010;82(10):51-6.

Abstract

AIM

To estimate the incidence and clinical value of metabolic syndrome, insulin resistance, and steatosis in patients with chronic hepatitis C (CHC) caused by its virus genotype 1.

SUBJECTS AND METHODS

One hundred and fourteen patients (67 men and 47 women; mean age 44.9 +/- 13.3 years) were examined.

RESULTS

There were high incidence rates of metabolic syndrome (47.2%) and insulin resistance (50%), in the genesis of which the host-virus interaction is discussed. There was an independent correlation of the insulin resistance and elevated leptin levels with abdominal obesity and hepatic steatosis; however, these indicators did not correlate with the stage of fibrosis. At the same time hepatic steatosis (found in 38% of the patients) and its degree correlated with the stage of fibrosis. Thirty-four of 66 (54.5%) patients receiving antiviral therapy achieved a stable virological response.

CONCLUSION

Obesity, hyperglycemia, and significant insulin resistance along with the stage of hepatic cirrhosis are independent cofactors that determine no treatment response.

摘要

目的

评估由1型丙型肝炎病毒(HCV)引起的慢性丙型肝炎(CHC)患者代谢综合征、胰岛素抵抗和脂肪变性的发生率及临床价值。

对象与方法

对114例患者(67例男性,47例女性;平均年龄44.9±13.3岁)进行检查。

结果

代谢综合征(47.2%)和胰岛素抵抗(50%)的发生率较高,并探讨了宿主-病毒相互作用在其发生过程中的作用。胰岛素抵抗和瘦素水平升高与腹型肥胖及肝脂肪变性存在独立相关性;然而,这些指标与纤维化分期无关。同时,肝脂肪变性(在38%的患者中发现)及其程度与纤维化分期相关。66例接受抗病毒治疗的患者中有34例(54.5%)实现了稳定的病毒学应答。

结论

肥胖、高血糖、显著的胰岛素抵抗以及肝硬化分期是决定无治疗应答的独立协同因素。

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