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氧化型低密度脂蛋白与慢性丙型肝炎患者的病毒载量和疾病活动度相关。

Oxidized low-density lipoprotein is associated with viral load and disease activity in patients with chronic hepatitis C.

机构信息

Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Tehran University of Medical Sciences, PO Box 13145-784, Tehran, Iran.

出版信息

Clin Res Hepatol Gastroenterol. 2011 Feb;35(2):111-6. doi: 10.1016/j.clinre.2010.11.001.

Abstract

BACKGROUND

The mechanisms of liver injury in chronic hepatitis C virus (HCV) infection are poorly understood. Recent evidence suggests that oxidative stress and lipid-peroxidation play a major role. The purpose of this study was to determine the serum level of oxidized low-density lipoprotein (ox-LDL), and evaluate its association with different clinically valuable parameters of liver disease in patients with chronic hepatitis C.

METHODS

Forty-five untreated chronic hepatitis C patients and 45 healthy adult volunteers, matched for age, sex and BMI, were enrolled. Blood samples were collected after 12 h of fasting, and serum bilirubin, albumin, liver aminotransferases, lipid profile, prothrombin time and ox-LDL were measured. Viral load of HCV was determined in patients. Liver biopsy was performed in patients and the stage of fibrosis and grade of necroinflammatory activity were determined. Healthy controls did not undergo liver biopsy.

RESULTS

Ox-LDL was significantly higher in HCV patients (42.54 ± 3.82 vs. 30.98 ± 1.66 μ/l, P < 0.01). Ox-LDL was significantly correlated to viral load (r = 0.457, P < 0.01), and grade of inflammation (r = 0.293, P < 0.05) in HCV patients. Ox-LDL was significantly higher in cirrhotic vs. noncirrhotic patients. No significant association was found between ox-LDL and Child-Pugh classification, serum albumin, liver enzymes, or prothrombin time.

CONCLUSION

This study provided new data from an in vivo setting which suggests the contribution of ox-LDL to HCV pathogenesis. Our results encourage further clinical studies to evaluate the potential diagnostic and therapeutic implications of ox-LDL in HCV patients.

摘要

背景

慢性丙型肝炎病毒(HCV)感染导致肝损伤的机制尚不清楚。最近的证据表明,氧化应激和脂质过氧化在其中起主要作用。本研究旨在测定氧化型低密度脂蛋白(ox-LDL)的血清水平,并评估其与慢性丙型肝炎患者不同临床有价值的肝脏疾病参数之间的相关性。

方法

纳入 45 例未经治疗的慢性丙型肝炎患者和 45 例年龄、性别和 BMI 相匹配的健康成年志愿者。采集空腹 12 小时后的血液样本,检测血清胆红素、白蛋白、肝转氨酶、血脂谱、凝血酶原时间和 ox-LDL。在患者中测定 HCV 病毒载量。对患者进行肝活检,并确定纤维化分期和坏死性炎症活动程度。健康对照组未进行肝活检。

结果

HCV 患者的 ox-LDL 显著升高(42.54 ± 3.82 比 30.98 ± 1.66 μl,P < 0.01)。ox-LDL 与 HCV 患者的病毒载量(r = 0.457,P < 0.01)和炎症程度(r = 0.293,P < 0.05)显著相关。ox-LDL 在肝硬化患者中显著高于非肝硬化患者。ox-LDL 与 Child-Pugh 分级、血清白蛋白、肝酶或凝血酶原时间之间无显著相关性。

结论

本研究从体内研究提供了新数据,提示 ox-LDL 对 HCV 发病机制的贡献。我们的结果鼓励进一步的临床研究来评估 ox-LDL 在 HCV 患者中的潜在诊断和治疗意义。

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