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抗病毒治疗对慢性丙型肝炎患者血脂谱的影响。

The effect of antiviral therapy on serum lipid profiles in chronic hepatitis C.

作者信息

Batsaikhan Batbold, Huang Ching-I, Yeh Ming-Lun, Huang Chung-Feng, Hou Nei-Jen, Lin Zu-Yau, Chen Shinn-Cherng, Huang Jee-Fu, Yu Ming-Lung, Chuang Wan-Long, Lee Jin-Ching, Dai Chia-Yen

机构信息

Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Department of Internal Medicine, Institute of Medical Sciences, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.

出版信息

Oncotarget. 2018 Apr 20;9(30):21313-21321. doi: 10.18632/oncotarget.25092.

Abstract

BACKGROUND

Low lipid profile is associated with hepatitis C virus (HCV) infection. Chronic HCV infection is the main cause of liver injury and serum lipid levels during antiviral treatment. We aimed to evaluate the effect of antiviral treatment on the change of lipid profiles during HCV treatment.

METHODS

Total 863 patients who complete the interferon-based therapy in Kaohsiung Medical University Hospital were included in this study. The lipid profile measured and evaluated in baseline and after 6 months of the treatment.

RESULTS

Sustained virological response (SVR) was achieved in 81.2% of all patients. The baseline triglycerides (TG) levels in the SVR group and non SVR groups were similar. The TG levels at 6 months after cessation of the treatment was significantly elevated in SVR group (102.9±57.0 mg/dL, p=0.0001) but did not elevated in non SVR group (94.5±45.6 mg/dL, p=0.690) compared with baseline TG levels. After adjusting patients by four indexes for fibrosis (FIB4) in cut-off point 3.25, serum TG levels significantly increased in low FIB4 group (103.2±57.9 mg/dL, p=0.0001) but not in high FIB4 group (98.1±49.6 mg/dL, p=0.095) after 6 months end of the treatment. Serum TG level was increased greater in patients who had low FIB4 score and patients who achieved SVR (baseline 89.1±34.8 mg/dL; 6 months after treatment 104.3±59.3 mg/dL, paired T test p=0.0001).

CONCLUSION

The clearance of the HCV RNA is the main determinant of the increase of lipids after PegIFN/RBV treatment. However advanced fibrosis also has an effect in increase of lipids after the treatment.

摘要

背景

低血脂与丙型肝炎病毒(HCV)感染相关。慢性HCV感染是肝损伤和抗病毒治疗期间血清脂质水平变化的主要原因。我们旨在评估抗病毒治疗对HCV治疗期间血脂变化的影响。

方法

本研究纳入了高雄医学大学医院863例完成基于干扰素治疗的患者。在基线和治疗6个月后测量并评估血脂。

结果

所有患者中81.2%实现了持续病毒学应答(SVR)。SVR组和非SVR组的基线甘油三酯(TG)水平相似。与基线TG水平相比,SVR组治疗停止6个月时TG水平显著升高(102.9±57.0mg/dL,p=0.0001),而非SVR组未升高(94.5±45.6mg/dL,p=0.690)。在根据纤维化的四个指标(FIB4)以3.25为界值对患者进行调整后,治疗6个月结束时,低FIB4组血清TG水平显著升高(103.2±57.9mg/dL,p=0.0001),而高FIB4组未升高(98.1±49.6mg/dL,p=0.095)。FIB4评分低且实现SVR的患者血清TG水平升高幅度更大(基线89.1±34.8mg/dL;治疗6个月后104.3±59.3mg/dL,配对T检验p=0.0001)。

结论

HCV RNA的清除是聚乙二醇干扰素/利巴韦林治疗后血脂升高的主要决定因素。然而,晚期纤维化对治疗后血脂升高也有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bd03/5940400/990d4da3f8ec/oncotarget-09-21313-g001.jpg

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