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非肥胖或 2 型糖尿病的慢性丙型肝炎病毒 1 型感染患者中的代谢综合征。

Metabolic syndrome in patients with chronic hepatitis C virus genotype 1 infection who do not have obesity or type 2 diabetes.

机构信息

Federal University of Bahia, Medicine and Health, Salvador, BA, Brazil.

出版信息

Clinics (Sao Paulo). 2012;67(3):219-23. doi: 10.6061/clinics/2012(03)03.

Abstract

OBJECTIVE

The individual components of metabolic syndrome may be independent predictors of mortality in patients with liver disease. We aimed to evaluate the prevalence of metabolic syndrome and its related components in hepatitis C virus-infected patients who are not obese and do not have type 2 diabetes.

METHODS

This cross-sectional study included 125 patients infected with hepatitis C virus genotype 1. Metabolic syndrome was defined according to the International Diabetes Federation. Anthropometric data were measured according to standardized procedures. Bioimpedance analysis was performed on all patients.

RESULTS

Metabolic syndrome was diagnosed in 21.6% of patients. Of the subjects with metabolic syndrome, 59.3% had hypertension, 77.8% had insulin resistance, 85.2% were overweight, 48.1% had a high waist circumference, 85.2% had an increased body fat percentage, and 92.3% had an elevated waist:hip ratio. In the bivariate analysis, female sex (OR 2.58; 95% CI: 1.09-6.25), elevated gamma-glutamyl transferase (γGT) (OR 2.63; 95% CI: 1.04-7.29), elevated fasting glucose (OR 8.05; 95% CI: 3.17-21.32), low HDL cholesterol (OR 2.80; 95% CI: 1.07-7.16), hypertriglyceridemia (OR 7.91; 95% CI: 2.88-22.71), elevated waist circumference (OR 10.33; 95% CI: 3.72-30.67), overweight (OR 11.33; 95% CI: 3.97-41.07), and increased body fat percentage (OR 8.34; 95% CI: 2.94-30.08) were independent determinants of metabolic syndrome. Using the final multivariate regression model, similar results were observed for abdominal fat (OR 9.98; 95% CI: 2.63-44.41) and total body fat percentage (OR 8.73; 95% CI: 2.33-42.34). However, metabolic syndrome risk was also high for those with blood glucose >5.55 mmol/L or HDL cholesterol <0.9 mmol/L (OR 16.69; 95% CI: 4.64-76.35; OR 7.23; 95% CI: 1.86-32.63, respectively).

CONCLUSION

Metabolic syndrome is highly prevalent among hepatitis C virus-infected patients without type 2 diabetes or obesity. Metabolic syndrome was significantly associated with hypertension, insulin resistance, increased abdominal fat, and overweight.

摘要

目的

代谢综合征的各个组成部分可能是肝病患者死亡的独立预测因素。我们旨在评估非肥胖且无 2 型糖尿病的丙型肝炎病毒感染者中代谢综合征及其相关成分的患病率。

方法

本横断面研究纳入了 125 名感染丙型肝炎病毒基因型 1 的患者。代谢综合征根据国际糖尿病联合会的标准进行定义。按照标准化程序测量人体测量数据。对所有患者进行生物阻抗分析。

结果

21.6%的患者诊断为代谢综合征。在患有代谢综合征的患者中,59.3%有高血压,77.8%有胰岛素抵抗,85.2%超重,48.1%腰围高,85.2%体脂肪百分比高,92.3%腰臀比高。在单因素分析中,女性(OR 2.58;95%CI:1.09-6.25)、γ-谷氨酰转移酶(γGT)升高(OR 2.63;95%CI:1.04-6.29)、空腹血糖升高(OR 8.05;95%CI:3.17-21.32)、高密度脂蛋白胆固醇降低(OR 2.80;95%CI:1.07-7.16)、高甘油三酯血症(OR 7.91;95%CI:2.88-22.71)、腰围升高(OR 10.33;95%CI:3.72-30.67)、超重(OR 11.33;95%CI:3.97-41.07)和体脂肪百分比增加(OR 8.34;95%CI:2.94-30.08)是代谢综合征的独立决定因素。使用最终的多元回归模型,也观察到腹部脂肪(OR 9.98;95%CI:2.63-44.41)和全身脂肪百分比(OR 8.73;95%CI:2.33-42.34)的类似结果。然而,血糖>5.55mmol/L 或高密度脂蛋白胆固醇<0.9mmol/L 的患者代谢综合征风险也很高(OR 16.69;95%CI:4.64-76.35;OR 7.23;95%CI:1.86-32.63)。

结论

在无 2 型糖尿病或肥胖的丙型肝炎病毒感染者中,代谢综合征的患病率很高。代谢综合征与高血压、胰岛素抵抗、腹部脂肪增加和超重显著相关。

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