在丙型肝炎病毒感染患者中，显性糖尿病与白细胞介素-28B 的非 CC 但非 CC 基因型相关。
Association of Overt Diabetes Mellitus with the Non-CC but not the CC Genotype of Interleukin-28B in Hepatitis C Virus Infected Patients.
机构信息
Institute of Liver, Gastroenterology, & Panceatico-Biliary Sciences, Sir Ganga Ram Hospital, New Delhi, India.
出版信息
J Clin Transl Hepatol. 2016 Mar 28;4(1):26-31. doi: 10.14218/JCTH.2016.00040. Epub 2016 Mar 15.
BACKGROUND
Interleukin-28B (IL-28B) polymorphism is an important predictor for hepatitis C virus (HCV) treatment response. Whether IL-28b genotypes also influence other nontreatment related clinical parameters is unclear.
METHODS
Patients with HCV-related chronic liver diseases who attended our department during 2012-2014 were retrospectively analyzed. The single nucleotide polymorphisms (SNPs) of rs12979860 (IL-28B) were correlated with various clinical parameters. We also compared these parameters in patients with and without overt diabetes to identify possible associations.
RESULTS
A total of 115 patients were included (median age 48, range 15-76 years; 70% males). Overall, 43/115 (37%) patients had chronic hepatitis, while the remaining 72/115 (63%) had cirrhosis. The most common IL-28B genotype was CC, which was found in 53% of patients (61/115), while the remaining 47% were nonCC [CT 42% (48/115) and TT 5% (6/115)]. Clinical and laboratory parameters like Hb, white blood cell (WBC), platelets, bilirubin, transaminases, and albumin were similar in the CC and nonCC genotypes. Overt diabetes mellitus was present in 22% (25/115) of patients. Patients with nonCC genotype had significantly higher prevalence of overt diabetes mellitus than patients with CC genotype (31% [17/54] versus 13% [8/61]; p < 0.05). When parameters were compared in patients with and without overt diabetes mellitus, only IL-28B and age were significantly associated with overt diabetes mellitus (p < 0.05).
CONCLUSION
In HCV patients, overt diabetes mellitus was more commonly associated with the nonCC genotype of IL-28B than the CC genotype. Carriers of the T-allele of SNP rs12979860 were more likely to have insulin resistance than CC homozygotes, and this finding may explain the higher prevalence of diabetes in non-CC genotypes. Thus, an IL-28B test may be useful in patients of HCV in order to determine their likelihood of developing diabetes mellitus.
背景
白细胞介素 28B（IL-28B）多态性是丙型肝炎病毒（HCV）治疗反应的重要预测因子。IL-28b 基因型是否也影响其他非治疗相关的临床参数尚不清楚。
方法
回顾性分析 2012-2014 年期间在我院就诊的 HCV 相关慢性肝病患者。分析 IL-28B 单核苷酸多态性（SNP）rs12979860 与各种临床参数的相关性。我们还比较了伴有和不伴有显性糖尿病患者的这些参数，以确定可能的关联。
结果
共纳入 115 例患者（中位年龄 48 岁，范围 15-76 岁；70%为男性）。总体而言，43/115（37%）例患者患有慢性肝炎，而其余 72/115（63%）例患者患有肝硬化。最常见的 IL-28B 基因型为 CC，占 53%（61/115），其余 47%为非 CC[CT 占 42%（48/115），TT 占 5%（6/115）]。CC 和非 CC 基因型的血红蛋白（Hb）、白细胞（WBC）、血小板、胆红素、转氨酶和白蛋白等临床和实验室参数相似。显性糖尿病的发生率为 22%（25/115）。非 CC 基因型患者显性糖尿病的发生率明显高于 CC 基因型患者（31%[17/54]与 13%[8/61]；p<0.05）。在比较有和无显性糖尿病患者的参数时，只有 IL-28B 和年龄与显性糖尿病显著相关（p<0.05）。
结论
在 HCV 患者中，显性糖尿病与 IL-28B 的非 CC 基因型比 CC 基因型更为常见。SNP rs12979860 的 T 等位基因携带者比 CC 纯合子更有可能出现胰岛素抵抗，这一发现可能解释了非 CC 基因型中糖尿病患病率较高的原因。因此，在 HCV 患者中进行 IL-28B 检测可能有助于确定其发生糖尿病的可能性。
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