Liu Xudong, Shen Zhen, Zhang Hongxing, Liang Jian, Lin Hai
1 Department of Liver Disease, Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine , Nanning, China .
2 Department of Liver Disease, Huangshi Traditional Chinese Medicine , Huangshi, China .
J Interferon Cytokine Res. 2016 Jun;36(6):367-73. doi: 10.1089/jir.2015.0129. Epub 2016 Feb 3.
Nonalcoholic fatty liver disease (NAFLD) becomes a characteristic of liver disease. Interleukin-21 (IL-21) plays an important role in the control of chronic hepatitis B (CHB). We aimed to investigate the relationship between IL-21 and early (24 weeks) viral response (EVR) to antiviral therapy in patients with coexistence of CHB and NAFLD (CHB + NAFLD). A prospective study was carried out in hepatitis B e antigen (HBeAg)-positive CHB + NAFLD and CHB patients receiving Entecavir for initial antiviral therapy, by recording demographic, anthropometric, and clinical data at baseline 12 and 24 weeks. Univariate analysis, correlation analysis, and receiver operating characteristic curve (ROC) were applied to find related factors with EVR. Forty CHB + NAFLD patients and 20 CHB patients entered final analysis. At baseline, IL-21, triglyceride (TG), cholesterol (CHOL), glutanyltransferase (GGT), body mass index (BMI), and computed tomography (CT) ratio of liver/spleen showed significant difference between the 2 groups. Although no significant difference was found, EVR rates was lower in CHB + NAFLD than CHB (75% vs. 90%, P = 0.053). Baseline IL-21 was associated with BMI, CT ratio of liver/spleen, TG, CHOL, and HBeAg level in CHB + NAFLD patients, whose IL-21, alanine aminotransferase, aspartate aminotransferase, CHOL, BMI, and CT ratio of liver/spleen at baseline was associated with EVR. Only the level of IL-21 exhibited significant increase from 0 to 12 weeks, while the change line of other associated factors was nearly parallel between EVR group and non-EVR group. ROC discovered the level of IL-21 at 12 weeks implied a strong predictive value for EVR. We deduced that IL-21 was associated with EVR, and the elevated level of IL-21 at treatment week 12 can predict EVR in CHB + NAFLD patients.
非酒精性脂肪性肝病（NAFLD）已成为肝脏疾病的一个特征。白细胞介素-21（IL-21）在慢性乙型肝炎（CHB）的控制中发挥着重要作用。我们旨在研究CHB与NAFLD并存（CHB+NAFLD）患者中IL-21与抗病毒治疗早期（24周）病毒学应答（EVR）之间的关系。对接受恩替卡韦初始抗病毒治疗的乙肝e抗原（HBeAg）阳性CHB+NAFLD和CHB患者进行了一项前瞻性研究，记录基线、12周和24周时的人口统计学、人体测量学和临床数据。采用单因素分析、相关性分析和受试者工作特征曲线（ROC）来寻找与EVR相关的因素。40例CHB+NAFLD患者和20例CHB患者进入最终分析。基线时，两组间IL-21、甘油三酯（TG）、胆固醇（CHOL）、谷氨酰转移酶（GGT）、体重指数（BMI）和肝脏/脾脏计算机断层扫描（CT）比值存在显著差异。虽然未发现显著差异，但CHB+NAFLD患者的EVR率低于CHB患者（75%对90%，P=0.053）。基线IL-21与CHB+NAFLD患者的BMI、肝脏/脾脏CT比值、TG、CHOL和HBeAg水平相关，其基线时的IL-21、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、CHOL、BMI和肝脏/脾脏CT比值与EVR相关。仅IL-21水平在0至12周时有显著升高，而其他相关因素的变化曲线在EVR组和非EVR组之间几乎平行。ROC发现12周时的IL-21水平对EVR具有较强的预测价值。我们推断IL-21与EVR相关，治疗第12周时IL-21水平升高可预测CHB+NAFLD患者的EVR。
