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丙型肝炎病毒感染与冠状动脉和胸主动脉粥样硬化的关系。

Hepatitis C virus infection associated with coronary and thoracic aortic atherosclerosis.

机构信息

Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital; School of Medicine and Hepatitis Research Center, College of Medicine and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.

Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital; School of Medicine and Hepatitis Research Center, College of Medicine and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Am J Med Sci. 2024 Sep;368(3):203-213. doi: 10.1016/j.amjms.2024.02.004. Epub 2024 Feb 16.

Abstract

BACKGROUND

Coronary and thoracic aortic calcification was associated with stroke, coronary heart, and peripheral vascular disease. Hepatitis C virus (HCV) infection is significantly associated with insulin resistance, diabetes mellitus and hepatic steatosis. We aimed to investigate the relationship between HCV infection and coronary, thoracic aortic atherosclerosis.

MATERIALS AND METHODS

Calcification was detected by chest computed tomography and defined as any Agatston score greater than zero. Metabolic syndrome was based on the modified Adult Treatment Panel III criteria. Fibrosis-4 (FIB-4) and AST-to-platelet ratio (APRI) was calculated. The anti-HCV signal-to-cutoff (S/CO) ratio was determined by the third generation ELISA kit. Atherosclerosis risk was estimated by using multiple logistic regression modeling.

RESULTS

Being positive for both metabolic syndrome and HCV infection (OR = 2.65, 95% CI: 1.26-5.59, p = 0.007), negative for metabolic syndrome and positive for HCV infection (OR = 2.75, 95% CI: 1.48-5.30, p = 0.001), and positive for metabolic syndrome and negative for HCV infection (OR = 2.42, 95% CI: 1.92-3.07, p < 0.001) were associated with atherosclerosis compared with being negative for both metabolic syndrome and HCV infection (P< 0.001). HCV infection with liver fibrosis (HCV; OR = 2.16, 95% CI: 1.22-3.82, p = 0.008), or (HCV; OR = 3.40, 95% CI: 1.28-9.06, p = 0.014) and elevated anti-HCV S/CO ratio (anti-HCV; OR = 1.72, 95% CI: 1.01-2.93, p = 0.045) was associated with atherosclerosis.

CONCLUSIONS

HCV infection with metabolic syndrome, liver fibrosis and elevated anti-HCV S/CO ratio was associated with atherosclerosis.

摘要

背景

冠状动脉和胸主动脉钙化与中风、冠心病和外周血管疾病有关。丙型肝炎病毒(HCV)感染与胰岛素抵抗、糖尿病和肝脂肪变性显著相关。我们旨在研究 HCV 感染与冠状动脉、胸主动脉粥样硬化的关系。

材料和方法

通过胸部计算机断层扫描检测钙化,并将任何 Agatston 评分大于零定义为钙化。代谢综合征基于改良的成人治疗小组 III 标准。计算纤维化-4(FIB-4)和天冬氨酸转氨酶与血小板比值(APRI)。抗-HCV 信号与截止值(S/CO)比值由第三代 ELISA 试剂盒确定。使用多元逻辑回归模型估计动脉粥样硬化风险。

结果

代谢综合征和 HCV 感染均阳性(OR=2.65,95%CI:1.26-5.59,p=0.007)、代谢综合征阴性而 HCV 感染阳性(OR=2.75,95%CI:1.48-5.30,p=0.001)和代谢综合征阳性而 HCV 感染阴性(OR=2.42,95%CI:1.92-3.07,p<0.001)与动脉粥样硬化相关,与代谢综合征和 HCV 感染均阴性相比(P<0.001)。HCV 感染合并肝纤维化(HCV;OR=2.16,95%CI:1.22-3.82,p=0.008)或(HCV;OR=3.40,95%CI:1.28-9.06,p=0.014)和升高的抗-HCV S/CO 比值(抗-HCV;OR=1.72,95%CI:1.01-2.93,p=0.045)与动脉粥样硬化相关。

结论

代谢综合征、肝纤维化和升高的抗-HCV S/CO 比值合并 HCV 感染与动脉粥样硬化有关。

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