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从实验室到临床:丙型肝炎病毒(HCV)基因型与蛋白尿危险因素的临床及生物医学研究

From Bench to Bedside: Clinical and Biomedical Investigations on Hepatitis C Virus (HCV) Genotypes and Risk Factors for Albuminuria.

作者信息

Hsiao Po-Jen, Hsiao Chia-Jen, Tsai Fu-Ru, Hou Yen-Lin, Chiu Chih-Chien, Chiang Wen-Fang, Wu Kun-Lin, Li Yuan-Kuei, Lin Chen, Chan Jenq-Shyong, Chang Chi-Wen, Chu Chi-Ming

机构信息

Division of Nephrology, Department of Internal Medicine, Armed Forces Taoyuan General Hospital, Taoyuan 325, Taiwan.

Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.

出版信息

Bioengineering (Basel). 2022 Sep 27;9(10):509. doi: 10.3390/bioengineering9100509.

Abstract

An extrahepatic manifestation of nephropathies can be a feature of the chronic hepatitis C virus (HCV) infection. Albuminuria is a major risk factor for nephropathies and chronic kidney disease (CKD). The correlation between HCV genotypes and albuminuria is still unclear. In this study, investigations have been done for the biomedical tools and methodologies used in the National Health and Nutrition Examination Survey (NHANES) public database. We searched the 2007−2016 NHANES public database to retrieve data regarding the different HCV genotypes and clinical scenarios. This study attempted to investigate the impacts of HCV genetic diversity, associated comorbidities, and racial differences on albuminuria. The urine albumin/creatinine ratio (ACR) was the primary endpoint. Among 40,856 participants, 336 participants with positive and 237 with negative HCV RNA tests were analyzed, excluding 14,454 participants with negative HCV antibodies and 25,828 which were missed. After controlling for sex, race, education level, smoking, diabetes mellitus, hepatitis B, alcohol use, and body mass index (BMI) with a generalized linear equation, HCV genotype 2 was more likely than any other genotype to cause albuminuria based on the urine ACR (p < 0.001). The generalized linear equation also demonstrated a significantly higher urine ACR, including hepatitis B (p < 0.001), diabetes mellitus (p < 0.001), and smoking (p = 0.026). In summary, the patients with HCV genotype 2 presented with increased albuminuria in comparison with other HCV genotypes in this 10-year retrospective analysis. HCV infection could be a risk factor of CKD; early diagnosis and appropriate treatment may improve clinical outcomes.

摘要

肾病的肝外表现可能是慢性丙型肝炎病毒(HCV)感染的一个特征。蛋白尿是肾病和慢性肾脏病(CKD)的主要危险因素。HCV基因型与蛋白尿之间的相关性仍不清楚。在本研究中,我们对国家健康与营养检查调查(NHANES)公共数据库中使用的生物医学工具和方法进行了调查。我们检索了2007 - 2016年NHANES公共数据库,以获取有关不同HCV基因型和临床情况的数据。本研究试图调查HCV基因多样性、相关合并症和种族差异对蛋白尿的影响。尿白蛋白/肌酐比值(ACR)是主要终点。在40,856名参与者中,分析了336名HCV RNA检测呈阳性和237名呈阴性的参与者,排除了14,454名HCV抗体呈阴性的参与者以及25,828名缺失数据的参与者。在用广义线性方程控制性别、种族、教育水平、吸烟、糖尿病、乙型肝炎、饮酒和体重指数(BMI)后,基于尿ACR,HCV 2型比其他任何基因型更有可能导致蛋白尿(p < 0.001)。广义线性方程还显示,包括乙型肝炎(p < 0.001)、糖尿病(p < 0.001)和吸烟(p = 0.026)在内,尿ACR显著更高。总之,在这项为期10年的回顾性分析中,与其他HCV基因型相比,HCV 2型患者的蛋白尿增加。HCV感染可能是CKD的一个危险因素;早期诊断和适当治疗可能改善临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/854b/9598589/c77d7ed5b4ef/bioengineering-09-00509-g001.jpg

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