肾功能下降与乙型肝炎、ALT升高

肝胆速递

Clin J Am Soc Nephrol. 2012 Aug 2. [Epub ahead of print]
Association of Reduced Renal Function with Hepatitis B Virus Infection and Elevated Alanine Aminotransferase.
Cai J, Fan X, Mou L, Gao B, Liu X, Li J, Liu L, Wang H, Guo Z, Liu X, Li H, Li X, Li X.
Source

Departments of Nephrology and, §Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China;, †Clinical Epidemiology Unit, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China, ‡Department of Nephrology, Pinggu Hospital of Beijing, Beijing, China.
Abstract
BACKGROUND AND OBJECTIVES:

Clinically, hepatitis B virus (HBV) infection is observed to be associated with nephropathy. However, previous population-based studies failed to show an association between HBV infection and CKD. Therefore, this cross-sectional study was designed to further explore this association.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:

A representative sample of 6854 Chinese adults aged 30-75 years was tested for levels of serum hepatitis B surface antigen, alanine aminotransferase (ALT), creatinine, urinary albumin/creatinine ratio, and potential CKD risk factors.
RESULTS:

Neither HBV infection nor elevated ALT (ALT+; ≥ sex-specific 90th percentile of ALT levels of noninfected persons) was significantly associated with reduced estimated GFR (eGFR < 60 ml/min per 1.73 m(2)). Compared with noninfected persons, HBV-infected persons with ALT+, but not those with ALT- (P=0.26), were more likely to have reduced eGFR (odds ratio, 4.07; 95% confidence interval, 1.18-14.0; P=0.03). Further analysis with a general linear model revealed a significant difference in eGFR (mean ± SEM) between HBV-infected and noninfected persons (87.8±0.8 versus 90.2±0.4 ml/min per 1.73 m(2); P=0.002). This difference was mainly derived from that between HBV-infected persons with ALT+ and noninfected persons, with an average difference in eGFR of -4.5 (95% confidence interval, -0.9 to -8.1; P=0.01). HBV infection and ALT+, alone or in combination, were not significantly associated with albuminuria or CKD.
CONCLUSIONS:

HBV infection with elevated ALT, rather than HBV infection alone, was associated with reduced renal function.
临床研究SOC Nephrol。 2012年8月2日。 [EPUB的提前打印]
协会与B型肝炎病毒感染与谷丙转氨酶升高，肾功能减退。
范X，J，蔡谋高B，L，王华，刘李江，刘X，L，郭正堂，刘，李瀚，李新，李新
源

肾脏病，部门§传染病，北京协和医院，中国科学院，中国医学科学院，北京，†临床流行病学单位，北京协和医院，中国医学科学院，北京，中国，‡部肾内科，北京平谷区医院，北京，中国。
抽象
背景和目的：

临床上，观察到B型肝炎病毒（HBV）感染是肾病关联。然而，以往的基于人口的研究显示HBV感染和慢性肾脏病之间的关联。因此，本横断面研究，目的是要进一步探索这个协会。
设计，场所，对象，与测量：

具有代表性的6854中国年龄在30-75岁的成年人进行了测试水平的血清乙肝表面抗原，谷丙转氨酶（ALT），肌酐，尿白蛋白/肌酐比值，和潜在的CKD的危险因素。
结果：

无论是HBV感染与ALT升高（ALT +≥性别第90百分位的未感染者的ALT水平）显着相关的降低估计肾小球滤过率（eGFR的<60毫升/每分钟1.73米（2））。与未感染者，HBV感染者ALT +，但不是那些与ALT（P = 0.26）相比，更有可能减少表皮生长因子（比值比为4.07，95％可信区间，1.18-14.0; P = 0.03） 。进一步的分析与一般线性模型揭示了HBV病毒感染者和非感染者（87.8±0.8比90.2±0.4毫升/每分钟1.73米（2），P = 0.002）之间的显着差异，表皮生长因子受体（平均值±SEM）。这种差异主要来自HBV感染者ALT +和未感染的人之间的差异，表皮生长因子受体平均为-4.5（95％可信区间，-0.9至-8.1，P = 0.01）。 HBV感染与ALT +，单独或组合，并没有显着伴有蛋白尿或CKD。

结论：

感染乙肝病毒并伴随ALT升高（非单纯感染病毒）与肾功能下降相关。

MP4

CJASN：HBV且ALT升高的患者须警惕肾功能减退作者：医脉通 来源：医脉通 2012-8-20 15:33:37 0 0

关键词： HBV ALT 肾功能


中国医学科学院北京协和医院肾内科李学旺教授等研究显示，感染乙型肝炎病毒（HBV）且丙氨酸氨基转移酶（ALT）升高的患者，容易出现肾功能减退。相关论文8月2日在线发表于《美国肾病学会临床杂志》（Clinical Journal of American Society Nephrology）。

研究共纳入6854例年龄在30~75岁间的成人受试者，检测血清HBV表面抗原、ALT、血肌酐、尿蛋白/肌酐比值及慢性肾脏病（CKD）的危险因素。

结果显示，单纯的HBV感染或ALT水平升高（≥非HBV感染、性别特异性人群ALT水平的90%百分位）与肾小球滤过率估算值 [eGFR < 60 ml/（min·1.73 m2）] 降低无明显相关性。与非HBV感染患者相比，HBV感染且ALT升高的患者容易出现eGFR降低（比值比为4.07，P=0.03）。进一步的线性模型统计分析证实，与非HBV感染患者相比，HBV感染且ALT升高患者eGFR平均降低4.5 ml/（min·1.73 m2），P=0.01。研究者还发现，HBV和ALT升高（单独或联合）与蛋白尿或CKD无明显相关性。（生物谷Bioon.com）

http://www.bioon.com/biology/biomed/528384.shtml

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