Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology and Infectious Diseases, University Hospital Regensburg, 93053, Regensburg, Germany.
Department of Internal Medicine, Klinikum Fürstenfeldbruck, 82256, Fürstenfeldbruck, Germany.
Lipids Health Dis. 2022 Oct 24;21(1):106. doi: 10.1186/s12944-022-01715-w.
Hepatitis C virus (HCV) infection is associated with serum lipid abnormalities, which partly normalize following direct-acting antiviral (DAA) therapy. Here, associations of serum triglycerides (TGs) with viral genotype and markers of liver disease severity were evaluated in patients with chronic HCV. METHODS: The study included the serum of 177 patients with chronic HCV. TGs were quantified by flow injection analysis Fourier transform mass spectrometry. Laboratory values and noninvasive scores for liver fibrosis assessment were determined. The nonparametric Kruskal‒Wallis test, one-way ANOVA, multiple linear regression and Student's t test were used as appropriate. P values were adjusted for multiple comparisons.
HCV-infected women had lower serum TGs than men, and thus, a sex-specific analysis was performed. None of the 46 TG species analyzed differed in the serum of female patients with and without liver cirrhosis. In contrast, in the serum of male patients with liver cirrhosis, TGs with 53, 56 and 58 carbon atoms and three to eight double bonds were diminished. These polyunsaturated TGs were also low in males with a high fibrosis-4 score. TGs with 7 or 8 double bonds negatively correlated with the model of end-stage liver disease score in males. In addition, TGs with 49, 51 and 53 carbon atoms were reduced in male patients infected with genotype 3a in comparison to genotype 1a. TGs with 56 carbon atoms were lower in genotype 3a-infected males than in genotype 1b-infected males. TGs did not differ in females by genotype. Genotype 3-related changes disappeared at the end of therapy with DAAs. Overall, the levels of serum TGs did not change during DAA therapy in either sex. Consequently, the serum TGs of males with liver cirrhosis were lower than those of males without cirrhosis at the end of therapy. Such a difference was not apparent in females.
The decline in TGs observed only in male patients with liver cirrhosis and male patients infected with genotype 3 illustrates sex-specific changes in lipid metabolism in chronic HCV.
丙型肝炎病毒（HCV）感染与血清脂质异常有关，这些异常在直接作用抗病毒（DAA）治疗后部分恢复正常。在此，评估了慢性 HCV 患者血清三酰甘油（TGs）与病毒基因型和肝脏疾病严重程度标志物之间的关系。
该研究纳入了 177 例慢性 HCV 患者的血清。采用流动注射分析傅里叶变换质谱法定量 TGs。测定实验室值和用于评估肝纤维化的非侵入性评分。适当使用非参数 Kruskal-Wallis 检验、单向方差分析、多元线性回归和学生 t 检验。对 P 值进行了多重比较的调整。
HCV 感染女性的血清 TGs 低于男性，因此进行了性别特异性分析。在无肝硬化的女性患者与有肝硬化的女性患者的血清中，分析的 46 种 TG 中没有一种存在差异。相比之下，在有肝硬化的男性患者的血清中，碳原子数为 53、56 和 58 且具有三至八个双键的 TG 减少。在纤维化-4 评分较高的男性中，这些多不饱和 TG 也较低。在男性中，具有 7 或 8 个双键的 TG 与终末期肝病模型评分呈负相关。此外，与基因型 1a 相比，基因型 3a 感染的男性患者的 TG 减少了碳原子数为 49、51 和 53 的 TG。与基因型 1b 感染的男性相比，基因型 3a 感染的男性患者的 TG 减少了碳原子数为 56 的 TG。在女性中，基因型之间的 TG 无差异。DAA 治疗结束时，基因型 3 相关的变化消失。总体而言，在 DAA 治疗期间，无论男女，血清 TGs 水平均未发生变化。因此，在治疗结束时，肝硬化男性的血清 TGs 低于非肝硬化男性。在女性中，这种差异并不明显。
仅在肝硬化男性和基因型 3 感染男性患者中观察到的 TG 下降表明慢性 HCV 中存在性别特异性的脂质代谢变化。
