长期核苷类似物对慢性乙型肝炎患者脂肪因子与肝脂肪变性

StephenW

Liver Int. 2019 Mar 25. doi: 10.1111/liv.14104. [Epub ahead of print]
Association of adipokines with hepatic steatosis and fibrosis in chronic hepatitis B patients on long-term nucleoside analogue.
Mak LY1, Lee CH1,2, Cheung KS1, Wong DK1,3, Liu F1, Hui RWH1, Fung J1,3, Xu A1,4,5, Lam KS1, Yuen MF1,3, Seto WK1,3,6.
Author information

1
    Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
2
    Research Centre of Heart, Brain, Hormone and Healthy Aging, The University of Hong Kong, Hong Kong.
3
    State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong.
4
    Department of Pharmacology& Pharmacy, The University of Hong Kong.
5
    State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong.
6
    Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.

Abstract
BACKGROUND & AIMS:

It is unknown how concomitant hepatic steatosis affects disease progression in chronic hepatitis B (CHB). Adipokines such as fibroblast growth factor 21 (FGF21) and adipocyte fatty acid-binding protein (AFABP) have been associated with non-alcoholic fatty liver disease. We determined the significance of these metabolic markers in CHB-related liver injury.
METHODS:

We recruited CHB patients on antiviral treatment for transient elastography assessment to determine liver stiffness (advanced fibrosis/cirrhosis, F3/F4, defined by EASL-ALEH criteria) and controlled attenuation parameter (hepatic steatosis, defined as ≥248 dB/m). Plasma FGF-21, AFABP and adiponectin levels were measured.
RESULTS:

415 patients [mean age 59.6 years, 71.6% male, median treatment duration 6.2 years] were recruited. Patients with F3/F4 (N=151) had lower FGF-21 (11.7 vs. 13.6 pg/mL, p=0.055), higher AFABP (126.8 vs. 84.1 pg/mL, p<0.001) and HOMA-IR (7.1 vs. 5.1, p=0.004) levels compared to those without F3/F4 (N=264). Multivariate analysis showed that FGF-21 level was associated with hepatic steatosis (OR 1.005, 95%CI 1.001-1.009) and F3/F4 (OR 0.993, 95%CI 0.989-0.998), while AFABP level (OR 1.001, 95%CI 1-1.002), body mass index (BMI) (OR 1.107, 95%CI 1.037-1.182) and presence of diabetes mellitus (OR 2.059, 95%CI 1.206-3.516) were associated with F3/F4. With the combined presence of BMI ≥25 kg/m2 , diabetes and AFABP >105.9 pg/mL, the odds ratio for F3/F4 was 3.712 (95%CI 1.364-10.105, p=0.010).
CONCLUSIONS:

Low FGF-21 and high AFABP levels were associated with advanced fibrosis/cirrhosis in CHB patients on antiviral treatment. Plasma AFABP, together with other metabolic risk factors, may aid identification of patients lacking fibrosis improvement during antiviral treatment. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.
KEYWORDS:

chronic hepatitis B; fatty liver disease; liver fibrosis; nucleoside analogues

PMID:
    30912255
DOI:
    10.1111/liv.14104

StephenW

肝脏国际2019年3月25日doi：10.1111 / liv.14104。 [印刷前的电子版]
长期核苷类似物对慢性乙型肝炎患者脂肪因子与肝脂肪变性和纤维化的关系。
Mak LY1，Lee CH1,2，Cheung KS1，Wong DK1,3，Liu F1，Hui RWH1，Fung J1,3，Xu A1,4,5，Lam KS1，Yuen MF1,3，Seto WK1,3,6。
作者信息

1
    香港大学玛丽医院医学系，香港。
2
    香港大学心脏，脑，激素和健康老龄研究中心。
3
    香港大学肝脏研究国家重点实验室。
4
    香港大学药理学及药学系。
五
    香港大学药物生物技术国家重点实验室。
6
    香港大学医学系 - 深圳医院，深圳，中国。

抽象
背景与目的：

目前尚不清楚伴随的肝脂肪变性如何影响慢性乙型肝炎（CHB）的疾病进展。脂肪细胞因子如成纤维细胞生长因子21（FGF21）和脂肪细胞脂肪酸结合蛋白（AFABP）与非酒精性脂肪肝疾病有关。我们确定了这些代谢标志物在CHB相关肝损伤中的重要性。
方法：

我们招募CHB患者进行抗病毒治疗，进行瞬时弹性成像评估以确定肝硬度（晚期纤维化/肝硬化，F3 / F4，由EASL-ALEH标准定义）和受控衰减参数（肝脂肪变性，定义为≥248dB/ m）。测量血浆FGF-21，AFABP和脂联素水平。
结果：

招募了415名患者[平均年龄59.6岁，男性71.6％，中位治疗时间6.2岁]。 F3 / F4患者（N = 151）FGF-21较低（11.7对13.6 pg / mL，p = 0.055），AFABP较高（126.8对84.1 pg / mL，p <0.001）和HOMA-IR（7.1与没有F3 / F4的那些相比，相对于5.1，p = 0.004）水平（N = 264）。多变量分析显示FGF-21水平与肝脂肪变性（OR 1.005,95％CI 1.001-1.009）和F3 / F4（OR 0.993,95％CI 0.989-0.998）相关，而AFABP水平（OR 1.001,95％CI） 1-1.002），体重指数（BMI）（OR 1.107,95％CI 1.037-1.182）和糖尿病（OR 2.059,95％CI 1.206-3.516）的存在与F3 / F4相关。当BMI≥25kg/ m2，糖尿病和AFABP> 105.9 pg / mL时，F3 / F4的优势比为3.712（95％CI 1.364-10.105，p = 0.010）。
结论：

在抗病毒治疗的CHB患者中，低FGF-21和高AFABP水平与晚期纤维化/肝硬化相关。血浆AFABP与其他代谢风险因子一起可以帮助鉴定在抗病毒治疗期间缺乏纤维化改善的患者。本文受版权保护。版权所有。

本文受版权保护。版权所有。
关键词：

慢性乙型肝炎;脂肪肝;肝纤维化;核苷类似物

结论：
    30912255
DOI：
    10.1111 / liv.14104