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血浆高密度脂蛋白胆固醇水平与肥胖慢性乙型肝炎患者肝硬化发展的相关性:一项队列研究。

The association of plasma high-density lipoprotein cholesterol levels and cirrhosis development in obese patients with chronic hepatitis B: a cohort study.

机构信息

School of Clinical Medicine.

Departments of Endocrinology.

出版信息

Eur J Gastroenterol Hepatol. 2021 May 1;33(5):738-744. doi: 10.1097/MEG.0000000000001965.

Abstract

OBJECTIVE

Metabolic disorder is a common risk factor for cirrhosis in Asia, and it will increase the risk of cirrhosis in patients with Chronic hepatitis B (CHB). However, studies on the efficacy of plasma lipid markers which predict the happening and development of cirrhosis in obese CHB patients are limited.

METHODS

In total, 3327 patients who were followed for more than 4 years' follow-up in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine joined the program. Finally, 287 obese CHB patients were included in this study according to the results of metabolic tests. The data of baseline and follow-up were collected, and the association between them was analyzed.

RESULTS

Based on the follow-up results, enrolled patients were divided into a group of cirrhosis (n = 146) and a group of noncirrhosis (n = 141). Plasma glucose and high-density lipoprotein cholesterol (HDL-C) levels in the noncirrhosis group (5.2 and 1.2 mmol/L, respectively) were significantly higher than that in the cirrhosis group (5.0 and 1.0 mmol/L, respectively), while the amount of total bile acid (TBA) in the cirrhosis group was lower than that in the cirrhosis group. Levels of HDL-C and total cholesterol were associated with liver function. Plasma HDL-C was an independent indicator of cirrhosis in patients with CHB. Patients with HDL-C levels less than 1.03 mmol/L had a 2.21-fold higher incidence rate of cirrhosis, and patients over 40 years old or the levels of HDL-C less than 1.03 mmol/L were more likely to generate cirrhosis.

CONCLUSIONS

Plasma HDL-C was an appropriate marker in predicting cirrhosis for patients with CHB.

摘要

目的

代谢紊乱是亚洲肝硬化的常见危险因素,它会增加慢性乙型肝炎(CHB)患者发生肝硬化的风险。然而,关于预测肥胖 CHB 患者肝硬化发生和发展的血浆脂质标志物的疗效研究有限。

方法

共纳入在成都中医药大学附属医院随访超过 4 年的 3327 例患者,根据代谢检查结果,最终纳入了 287 例肥胖 CHB 患者进行本研究。收集患者的基线和随访资料,分析两者之间的关系。

结果

根据随访结果,将纳入患者分为肝硬化组(n=146)和非肝硬化组(n=141)。非肝硬化组的空腹血糖和高密度脂蛋白胆固醇(HDL-C)水平(分别为 5.2 和 1.2mmol/L)明显高于肝硬化组(分别为 5.0 和 1.0mmol/L),而肝硬化组的总胆汁酸(TBA)水平较低。HDL-C 和总胆固醇水平与肝功能相关。血浆 HDL-C 是 CHB 患者肝硬化的独立预测指标。HDL-C 水平低于 1.03mmol/L 的患者肝硬化发生率增加 2.21 倍,年龄大于 40 岁或 HDL-C 水平低于 1.03mmol/L 的患者更易发生肝硬化。

结论

血浆 HDL-C 是预测 CHB 患者肝硬化的合适标志物。

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