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目的探讨慢性丙型肝炎(CHC)并发脂肪肝患者血清网膜素水平及其与代谢因素的相关性。方法选择初次就诊未进行抗病毒治疗的93例CHC患者,根据患者是否伴有脂肪性肝病(FLD)将患者分为两组:FLD组(45例)和非FLD组(48例)。比较两组患者的一般状况,如性别、年龄、体重指数(BMI)、腰臀比(WHR)等;HCV基因型、病毒载量等病毒学相关指标;肝脏酶学指标(ALT、AST);血糖[空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)];血脂(TG、TC)以及网膜素水平等。结果 FLD组与非FLD组患者的BMI存在统计学差异。FLD组患者的TG水平明显高于非FLD组(P<0.05),而FLD组患者的ALT、AST、FINS、HOMA-IR以及血清网膜素水平明显低于非FLD组(P<0.05)。两组间病原学因素差异无统计学意义。血清网膜素水平与WHR、BMI、FINS、HOMA-IR、TG呈显著负相关。多元逐步回归分析发现,HOMA-IR是血清网膜素水平的独立相关因素(R2=0.889,P<0.01)。结论 CHC患者伴发FLD与血清网膜素水平下降密切相关,而血清网膜素水平与病毒本身无明确相关性。
Objective To investigate the relationship between serum retinin levels and metabolic factors in patients with chronic hepatitis C (CHC) complicated with fatty liver. Methods Ninety-three patients with CHC who did not undergo initial antiviral therapy were divided into two groups according to whether they had fatty liver disease (FLD): FLD group (n = 45) and non-FLD group (n = 48). The general conditions such as gender, age, body mass index (BMI) and WHR were compared between the two groups. Virology-related indices such as HCV genotype and viral load, liver enzymatic indexes (ALT, AST) Blood glucose (fasting blood glucose (FPG), fasting insulin (FINS), insulin resistance index (HOMA-IR)), blood lipid (TG, TC) Results There was a significant difference in BMI between FLD group and non-FLD group. The level of TG in FLD group was significantly higher than that in non-FLD group (P <0.05). The levels of ALT, AST, FINS, HOMA-IR and serum retinin in FLD group were significantly lower than those in non-FLD group (P <0.05). Etiological factors between the two groups showed no significant difference. Serum retinin levels were negatively correlated with WHR, BMI, FINS, HOMA-IR and TG. Multivariate stepwise regression analysis found that HOMA-IR was an independent correlate of serum retinin levels (R2 = 0.889, P <0.01). Conclusion There is a close relationship between FLD and serum levels of serum retinin in patients with CHC. The level of serum retinin is not related to the virus itself.