El-Gindy Eman M, Ali-Eldin Fatma A, Meguid Marwa A
Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Abbasseya Square, Cairo, Egypt.
Arab J Gastroenterol. 2012 Jun;13(2):54-7. doi: 10.1016/j.ajg.2012.05.001. Epub 2012 Jun 29.
Fatigue is one of the most common presenting symptoms of chronic hepatitis C virus (HCV) infection. Its pathogenesis has been poorly investigated. Serum leptin levels are increased in cirrhosis and are suggested to have a role in the mediation of fatigue. This study was designed to assess possible association of serum leptin levels with fatigue and severity of liver disease in Egyptian patients with chronic hepatitis C infection.
Seventy patients and 20 control subjects participated in the study. They were subjected to clinical and laboratory assessment, the determination of serum leptin level by ELISA and the assessment of fatigue using the multidimensional assessment of fatigue (MAF) scale. Respondents are asked to reflect on fatigue patterns for the past week. The MAF is a revision of the Piper Fatigue Scale.
Fatigue was present in all patients (100%) and 13 subjects of the control group (65%). There was a highly significant statistical difference between cases and controls regarding the presence and severity of fatigue. Serum leptin level was significantly higher in cases (24.9±28) in comparison to the control subjects (14.8±8). Serum leptin was not related to severity of liver disease as assessed by the Child Pugh classification. Serum leptin levels were directly correlated to the severity of fatigue (p<0.01) in patients but not in the control subjects.
Fatigue is highly prevalent in Egyptian patients with chronic HCV infection. Leptin might play a role in the mediation of fatigue in those patients drawing attention to biological basis of one of the most common symptoms facing clinician dealing with this problem.
疲劳是慢性丙型肝炎病毒（HCV）感染最常见的症状之一。其发病机制尚未得到充分研究。肝硬化患者血清瘦素水平升高，提示其在疲劳介导中发挥作用。本研究旨在评估埃及慢性丙型肝炎感染患者血清瘦素水平与疲劳及肝病严重程度之间的可能关联。
70例患者和20例对照者参与了本研究。他们接受了临床和实验室评估，通过酶联免疫吸附测定（ELISA）法测定血清瘦素水平，并使用疲劳多维评估（MAF）量表评估疲劳情况。要求受访者回顾过去一周的疲劳模式。MAF是派珀疲劳量表的修订版。
所有患者（100%）和13名对照组受试者（65%）存在疲劳。病例组和对照组在疲劳的存在和严重程度方面存在高度显著的统计学差异。与对照组受试者（14.8±8）相比，病例组血清瘦素水平显著更高（24.9±28）。根据Child-Pugh分类法评估，血清瘦素与肝病严重程度无关。患者血清瘦素水平与疲劳严重程度直接相关（p<0.01），而对照组受试者则不然。
疲劳在埃及慢性HCV感染患者中非常普遍。瘦素可能在这些患者的疲劳介导中发挥作用，这提请人们关注临床医生在处理这一问题时面临的最常见症状之一的生物学基础。
