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胰岛素抵抗与慢性丙型肝炎:与血清铁和铁调素的关系

Insulin Resistance and Chronic Hepatitis C: Relationship With Serum Iron and Hepcidin.

作者信息

Gill Maria, Ul Qamar Misbah, Ikram Faiza, Naz Shaheena, Sadaf Hina, Hafeez Zobiah

机构信息

Physiology, CMH Multan Institute of Medical Sciences, Multan, PAK.

Physiology, Akhtar Saeed Medical and Dental College, Lahore, PAK.

出版信息

Cureus. 2020 Dec 28;12(12):e12349. doi: 10.7759/cureus.12349.

Abstract

Backgrounds and aim Besides the clinical evidence supporting insulin resistance in chronic hepatitis C (CHC) patients, the exact mechanism elucidating insulin resistance is still under discussion. The present study aimed to observe any relationship between serum hepcidin, serum iron, and insulin resistance in CHC patients. Methodology A total of 54 individuals were recruited in this study, assorted into group A (CHC population with diabetes) and control group B (CHC population without diabetes). Both groups were tested for serum hepcidin, iron, ferritin, and serum glycemic indices (fasting blood glucose, serum insulin, and insulin resistance). Serum parameters were compared between diabetic and non-diabetic CHC patients by using the Mann-Whitney U test. Correlation analysis was done between serum hepcidin and serum iron, serum hepcidin, and insulin resistance, and serum iron and insulin resistance by applying the Spearman correlation test. Results Diabetic and non-diabetic CHC populations exhibited an iron profile of chronic illness, i.e., low serum iron and hepcidin along with normal ferritin levels. Also, the diabetic and non-diabetic CHC population exhibited normal serum insulin and insulin resistance. However, the fasting serum glucose of the diabetic CHC population was higher than normal. Correlation analysis indicated a negative significant correlation (rho=-0.404, p=0.036) between serum iron and insulin resistance among the diabetic CHC population. Conclusion Our study could not provide any mounting evidence in favor of insulin resistance in the chronic hepatitis C population via serum iron or hepcidin. Hepatitis C virus causing diabetes mellitus may have some etiology other than iron metabolism.

摘要

背景与目的 除了有临床证据支持慢性丙型肝炎(CHC)患者存在胰岛素抵抗外,阐明胰岛素抵抗的确切机制仍在讨论中。本研究旨在观察CHC患者血清铁调素、血清铁与胰岛素抵抗之间的关系。

方法 本研究共招募了54名个体,分为A组(患有糖尿病的CHC人群)和对照组B(未患糖尿病的CHC人群)。对两组均进行血清铁调素、铁、铁蛋白及血清血糖指标(空腹血糖、血清胰岛素和胰岛素抵抗)检测。采用Mann-Whitney U检验比较糖尿病和非糖尿病CHC患者的血清参数。应用Spearman相关检验对血清铁调素与血清铁、血清铁调素与胰岛素抵抗、血清铁与胰岛素抵抗之间进行相关分析。

结果 糖尿病和非糖尿病CHC人群均呈现慢性病的铁代谢特征,即血清铁和铁调素水平低,而铁蛋白水平正常。此外,糖尿病和非糖尿病CHC人群的血清胰岛素和胰岛素抵抗均正常。然而,糖尿病CHC人群的空腹血清葡萄糖高于正常水平。相关分析表明,糖尿病CHC人群中血清铁与胰岛素抵抗之间存在显著负相关(rho=-0.404,p=0.036)。

结论 我们的研究未能提供任何确凿证据支持血清铁或铁调素导致CHC人群出现胰岛素抵抗。丙型肝炎病毒导致糖尿病可能有铁代谢以外的其他病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a9f/7841015/82cdb05606b5/cureus-0012-00000012349-i01.jpg

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