Lenkei R, Cheţa D, Cristian R
Med Interne. 1980 Jan-Mar;18(1):75-82.
HBsAg presence was studied by counterelectrophoresis (CEP) in 76 patients with liver cirrhosis and in 431 patients with diabetes mellitus. A striking correlation was found between high blood glucose values and HBsAg absence. Thus, HBsAg-negative cirrhotics (53%) had significantly higher levels of glycemia than the HBsAg-positive patients of the same age group, i.e. 95.75 +/- 6.36 ng/100 ml compared to 78.30 +/- 10.2/100 ml. This absence of HBsAg was also observed in all diabetics but one. As the incidence of HBsAg (CEP) was found to be of 3.63% in 253,460 subjects from different areas of Romania and 6.84% in 14,690 subjects with various non-hepatic diseases included, the chance of finding the 0.2% HBsAg incidence observed in the diabetics would be less than 0.0002 and 0.0001, respectively. The serum HBsAg absence in cirrhotics with high glycemia and in diabetics strongly incriminates the constant high concentrations of blood glucose as the main factor responsible for this negativity. The effect may be direct on virus replication, or indirect, by metabolically-induced hepatic dysfunction interfering with HBsAg secretion or excretion. The presence of high concentrations of glucose in cell culture media might explain the repeated failure of hepatitis B virus serial passage in tissue or organ culture.
采用对流免疫电泳（CEP）研究了76例肝硬化患者和431例糖尿病患者的乙肝表面抗原（HBsAg）存在情况。研究发现，高血糖值与HBsAg阴性之间存在显著相关性。因此，HBsAg阴性的肝硬化患者（53%）的血糖水平显著高于同年龄组的HBsAg阳性患者，即分别为95.75±6.36 ng/100 ml和78.30±10.2/100 ml。除1例糖尿病患者外，所有糖尿病患者均观察到HBsAg阴性。由于在罗马尼亚不同地区的253,460名受试者中，HBsAg（CEP）的发生率为3.63%，在纳入的14,690名患有各种非肝脏疾病的受试者中为6.84%，那么在糖尿病患者中发现0.2%的HBsAg发生率的可能性分别小于0.0002和0.0001。高血糖的肝硬化患者和糖尿病患者血清中HBsAg阴性强烈表明持续的高血糖浓度是导致这种阴性结果的主要因素。这种影响可能直接作用于病毒复制，也可能是间接的，通过代谢诱导的肝功能障碍干扰HBsAg的分泌或排泄。细胞培养基中高浓度葡萄糖的存在可能解释了乙肝病毒在组织或器官培养中连续传代反复失败的原因。
