Chang Ming-Ling, Kuo Chia-Jung, Huang Hsin-Chih, Chu Yin-Yi, Chiu Cheng-Tang
Liver Research Center, Division of Hepatology, Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
PLoS One. 2016 Nov 21;11(11):e0166712. doi: 10.1371/journal.pone.0166712. eCollection 2016.
The association between leptin and complement in hepatitis C virus (HCV) infection remains unknown.
A prospective study was conducted including 474 (250 genotype 1, 224 genotype 2) consecutive chronic hepatitis C (CHC) patients who had completed an anti-HCV therapy course and undergone pre-therapy and 24-week post-therapy assessments of interferon λ3-rs12979860 and HCV RNA/genotypes, anthropometric measurements, metabolic and liver profiles, and complement component 3 (C3), C4, and leptin levels.
Of the 474 patients, 395 had a sustained virological response (SVR). Pre-therapy leptin levels did not differ between patients with and without an SVR. Univariate and multivariate analyses showed that sex (pre- and post-therapy, p<0.001), body mass index (BMI) (pre- and post-therapy, p<0.001), and C3 levels (pre-therapy, p = 0.027; post-therapy, p = 0.02) were independently associated with leptin levels with or without HCV infection. Pre-therapy BMI, total cholesterol (TC), C4 levels, and the rs12979860 genotype were independently associated with pre-therapy C3 levels in all patients. Post-therapy BMI, alanine aminotransferase, TC, C4 levels, white blood cell counts, and hepatic steatosis were independently associated with the post-therapy C3 levels of SVR patients. Compared with pre-therapy levels, SVR patients showed higher 24-week post-therapy C4 (20.32+/-7.30 vs. 21.55+/-7.07 mg/dL, p<0.001) and TC (171.68+/-32.67 vs. 186.97+/-36.09 mg/dL, p<0.001) levels; however, leptin and C3 levels remained unchanged after therapy in patients with and without an SVR.
Leptin and C3 may maintain immune and metabolic homeostasis through association with C4 and TC. Positive alterations in C4 and TC levels reflect viral clearance after therapy in CHC patients.
丙型肝炎病毒（HCV）感染中瘦素与补体之间的关联尚不清楚。
进行了一项前瞻性研究，纳入474例（250例基因1型，224例基因2型）连续的慢性丙型肝炎（CHC）患者，这些患者完成了抗HCV治疗疗程，并在治疗前以及治疗后24周进行了干扰素λ3-rs12979860和HCV RNA/基因型、人体测量、代谢和肝脏指标以及补体成分3（C3）、C4和瘦素水平的评估。
474例患者中，395例获得持续病毒学应答（SVR）。有和没有SVR的患者治疗前瘦素水平无差异。单因素和多因素分析显示，性别（治疗前后均p<0.001）、体重指数（BMI）（治疗前后均p<0.001）以及C3水平（治疗前，p = 0.027；治疗后，p = 0.02）无论有无HCV感染均与瘦素水平独立相关。所有患者中，治疗前BMI、总胆固醇（TC）、C4水平以及rs12979860基因型与治疗前C3水平独立相关。治疗后，BMI、丙氨酸转氨酶、TC、C4水平、白细胞计数以及肝脂肪变性与SVR患者治疗后的C3水平独立相关。与治疗前水平相比，SVR患者治疗后24周C4（20.32±7.30 vs. 21.55±7.07 mg/dL，p<0.001）和TC（171.68±32.67 vs. 186.97±36.09 mg/dL，p<0.001）水平升高；然而，有和没有SVR的患者治疗后瘦素和C3水平均未改变。
瘦素和C3可能通过与C4和TC的关联维持免疫和代谢稳态。C4和TC水平的正向改变反映了CHC患者治疗后病毒清除情况。
