Yang Qiao, Tong Yifan, Pi Borui, Yu Hong, Lv Fangfang
Department of Infectious Diseases, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Front Med (Lausanne). 2022 Apr 14;9:847091. doi: 10.3389/fmed.2022.847091. eCollection 2022.
The effect of metabolic factors on the risk of bacterial infections (BIs) in patients with hepatitis B virus (HBV)-related cirrhosis has not been demonstrated. This study aimed to explore specific metabolic factors associated with the BIs in these patients.
A population-based cohort of 471 patients with HBV-related cirrhosis was retrospectively enrolled between 2009 and 2019. The primary end point was the incidence of BIs during hospitalization, which were compared according to the metabolism-related indicators, namely, presence of diabetes, level of high-density lipoprotein cholesterol (HDLC) and triglyceride, and body mass index (BMI). The propensity score matching (PSM) was adopted to eliminate baseline discrepancies.
Compared with the non-diabetic group, the incidences of BIs were higher in the diabetic group before and after PSM ( = 0.029 and = 0.027). Similar results were found in the low HDLC group as compared with the normal HDLC group before and after PSM ( < 0.001 and = 0.025). Further analysis showed that the incidences of BIs in patients with low HDLC alone were lower than patients with both low HDLC and diabetes before and after PSM ( = 0.003 and = 0.022). Similarly, the incidence of BIs in patients with diabetes alone was lower than those in patients with both low HDLC and diabetes both before and after PSM ( = 0.002 and = 0.018). However, neither triglyceride nor BMI level was related to BIs in our cohort.
In patients with HBV-related cirrhosis, the presence of diabetes and low level of HDLC were risk factors of BIs, showing a synergistic effect.
代谢因素对乙型肝炎病毒（HBV）相关肝硬化患者细菌感染（BIs）风险的影响尚未得到证实。本研究旨在探索与这些患者BIs相关的特定代谢因素。
回顾性纳入2009年至2019年间471例HBV相关肝硬化患者的基于人群的队列。主要终点是住院期间BIs的发生率，根据代谢相关指标进行比较，即糖尿病的存在、高密度脂蛋白胆固醇（HDLC）和甘油三酯水平以及体重指数（BMI）。采用倾向评分匹配（PSM）来消除基线差异。
与非糖尿病组相比，糖尿病组在PSM前后BIs的发生率均较高（P = 0.029和P = 0.027）。与正常HDLC组相比，低HDLC组在PSM前后也有类似结果（P < 0.001和P = 0.025）。进一步分析表明，仅低HDLC患者的BIs发生率低于同时有低HDLC和糖尿病患者在PSM前后的发生率（P = 0.003和P = 0.022）。同样，仅糖尿病患者的BIs发生率低于同时有低HDLC和糖尿病患者在PSM前后的发生率（P = 0.002和P = 0.018）。然而，在我们的队列中，甘油三酯和BMI水平均与BIs无关。
在HBV相关肝硬化患者中，糖尿病的存在和低HDLC水平是BIs的危险因素，显示出协同作用。
