慢性HBV感染诱导的轻度炎症患者中胰岛素抵抗

StephenW

戴福宏等发现在慢性HBV感染诱导的轻度炎症患者中胰岛素抵抗的发生率高，并且可能与肝功能损害和人体质量指数相关，但与HBV DNA载量无关(戴福宏等，第517～521页)
Zhonghua Gan Zang Bing Za Zhi. <http://www.ncbi.nlm.nih.gov/pubmed/&gt; 2012 Jul;20(7):517-21. doi: 10.3760/cma.j.issn.1007-3418.2012.07.008.

[Assessment of the factors associated with insulin resistance in patients with chronic hepatitis B infection].

[Article in Chinese]

Dai FH, Zeng WQ, Jiang CY


Source

Department of Infectious Diseases, the Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China.

Abstract

To investigate the factors associated with insulin resistance (IR) in patients with chronic hepatitis B virus (HBV) infection. Methods Sixty- eight patients with mild chronic hepatitis B (MCHB) caused by HBV were recruited for study. Sixty-seven healthy individuals with no hepatitis virus infections and normal liver function were enrolled as controls. Demographic, anthropometric, clinical, and blood biochemical parameters were compared between the two groups. IR was determined by the homeostasis model assessment (HOMA-IR). The MCHB group was further divided into patients with IR (HOMA-IR: > 2.7) and patients without IR (HOMA-IR: less than 2.7). Demographic, anthropometric, clinical, and blood biochemical parameters were compared between the two sub-groups. Finally, the potential factors associated with IR were evaluated. Results Compared to the healthy controls, the MCHB patients had significantly higher serum insulin (Z = -5.451, P less than 0.01), alanine aminotransferase (ALT) (Z = -8.211, P less than 0.01) and HOMA-IR (Z = -5.631, P less than 0.01). IR was detected in 44.12% (30/68) of the MCHB patients. The levels of ALT and body mass index (BMI) were significantly different between the MCHB patients with IR and without IR (t = -2.358, and t = -3.566, P less than 0.05). There was a significant correlation between BMI, ALT, and HOMA-IR in the MCHB patients (r = 0.374, r = 0.282, P less than 0.05), but not with the HBV DNA loads (r = 0.015, P = 0.904). Binary logistic regression analysis indicated that BMI [Exp(B): 1.859, P less than 0.01] and ALT [Exp(B): 1.022, P less than 0.05] were independent risk factors of IR in MCHB. Conclusion There is a high prevalence of insulin resistance in patients with mild hepatitis caused by chronic HBV infection. In these patients, IR is correlated with abnormal liver function and BMI, and not HBV load.

StephenW

为了探讨慢性乙型肝炎病毒（HBV）感染患者与胰岛素抵抗（IR）的相关因素。被招募为研究方法对68例轻度慢性肝炎B（MCHB）的乙型肝炎病毒造成的。 67个健康人没有肝炎病毒感染和肝功能正常的患者作为对照组。两组之间的人口统计，人体测量学，临床和血液生化指标进行了比较。 IR测定的稳态模型评估（HOMA-IR）。 MCHB组又分为患者IR（HOMA-IR：> 2.7）和IR（HOMA-IR：小于2.7）的患者无。两个小组之间的人口统计，人体测量学，临床和血液生化指标进行了比较。最后，与IR的潜在因素进行了评价。结果与健康对照组相比，MCHB患者有显着较高的血清胰岛素（Z = -5.451，P小于0.01），丙氨酸氨基转移酶（ALT）（Z = -8.211，P小于0.01），HOMA-IR（Z = -5.631，P小于0.01）。 IR检测在44.12％（30/68）的MCHB患者。之间的MCHB患者IR和无IR（t = -2.358，与t = -3.566，P小于0.05），ALT水平和身体质量指数（BMI）显着不同的。有一个的MCHB患者相关（r = 0.374，R = 0.282，P小于0.05），BMI，ALT，HOMA-IR显着相关性，但与HBV DNA载量相关（r = 0.015，P = 0.904）。二分类Logistic回归分析表明，BMI [Exp（B）：1.859，P小于0.01]，ALT [Exp（B）：1.022，P小于0.05，在MCHB IR的独立危险因素。结论是在与轻度肝炎引起的慢性HBV感染患者胰岛素抵抗的发病率较高。在这些患者中，IR与肝功能异常和BMI，而不是HBV负荷

疯一点好

胰岛素抵抗是什么意思呢？这种患者是不是血糖升高？

StephenW

回复 疯一点好 的帖子

胰岛素抵抗是什么意思呢？这种患者是不是血糖升高？是, 2型糖尿病.

咬牙硬挺

感谢分享

wgx

回复 咬牙硬挺 的帖子

我就是这样胰岛素抵抗，不知到有什么办法治疗，苦呀。

wgx

回复 wgx 的帖子

我空腹血糖6.8左右，餐后8.9左右，不知道可不可以逆转，是先看好肝病，才可以治疗糖尿病

疯一点好

感谢斯帝芬。
我的血糖也偏高，最高达到6•8，有时候也会正常，不好。

StephenW

回复 疯一点好 的帖子

血糖高 - 改变饮食习惯，降低体重, 运动，运动和运动!

疯一点好

我也不是很胖啊，高160重125，不过很爱甜食，听从斯帝芬建议改变饮食习惯，增加运动量。我服贺维力将近5年，不敢停药啊，停药癌变几率会增高，纠结死了。目前各种检查都正常，但就是估计这种血糖的微升应该是肝功能处理血糖的能力不足导致的结果，但都是不好啊，恐癌焦虑症。