马来酸贝西福韦酯联合左旋肉碱对慢性乙型肝炎患者肝脂肪

StephenW

J Korean Med Sci. 2020 May 4;35(17):e104. doi: 10.3346/jkms.2020.35.e104.
Influence of Besifovir Dipivoxil Maleate Combined with L-Carnitine on Hepatic Steatosis in Patients with Chronic Hepatitis B.
Jung YW#1, Kim M#1, Kim BK1,2,3, Park JY1,2,3, Kim DY1,2,3, Ahn SH1,2,3, Han KH1,2,3, Kim SU1,2,4.
Author information

1
    Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
2
    Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
3
    Yonsei Liver Center, Severance Hospital, Seoul, Korea.
4
    Yonsei Liver Center, Severance Hospital, Seoul, Korea. [email protected].
#
    Contributed equally

Abstract
BACKGROUND:

Besifovir dipivoxil maleate (BSV) with L-carnitine is the first-line antiviral agent for chronic hepatitis B (CHB) infection. We investigated whether BSV combined with L-carnitine improves hepatic steatosis (HS).
METHODS:

Treatment-naïve patients with CHB who were initiated on antiviral therapy (AVT) were enrolled. The magnitude of HS was assessed using hepatic steatosis index (HSI), and HS improvement was defined as a ≥ 10% reduction in the HSI score from the baseline.
RESULTS:

The mean age of the study patients was 56 years with a male predominance (n = 178, 64.7%). The mean body mass index (BMI), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and platelet count were 23.5 kg/m², 49.6 IU/L, 49.0 IU/L, and 191.3 × 10⁹/L, respectively. The mean HSI and fibrosis (FIB)-4 index were 32.6 and 0.5, respectively. After 6 months of AVT, platelet count (mean, 191.3→167.0 × 10⁹/L), fasting glucose (mean, 113.1→105.9 mg/dL), AST (mean, 49.6→28.0 IU/L), ALT (mean, 49.0→33.9 IU/L), and total cholesterol (mean, 170.0→162.1 mg/dL) levels significantly decreased (all P < 0.05). In the BSV group, AST (mean, 95.2→30.2 IU/L) and ALT (mean, 81.1→31.1 IU/L) levels significantly reduced (all P < 0.05), whereas HSI and FIB-4 index were maintained (all P > 0.05). In the univariate analysis, age, BMI, diabetes, cirrhosis, fasting glucose level, and ALT were significantly associated with HS improvement (all P < 0.05).
CONCLUSION:

BSV with L-carnitine did not show any improvement of HS in patients with CHB. Further prospective randomized controlled studies are needed to validate the potential beneficial effects of BSV with L-carnitine in CHB infection.

© 2020 The Korean Academy of Medical Sciences.
KEYWORDS:

Besifovir; Entecavir; Hepatic Steatosis; L-carnitine; Tenofovir

PMID:
    32356416
DOI:
    10.3346/jkms.2020.35.e104

StephenW

韩国医学杂志。 2020年5月4日； 35（17）：e104。 doi：10.3346 / jkms.2020.35.e104。
马来酸贝西福韦酯联合左旋肉碱对慢性乙型肝炎患者肝脂肪变性的影响。
Jung YW＃1，Kim M＃1，Kim BK1,2,3，Park JY1,2,3，Kim DY1,2,3，Ahn SH1,2,3，Han KH1,2,3，Kim SU1,2， 4。
作者信息

1个
    延世大学医学院内科，韩国首尔。
2
    延世大学医学院胃肠病研究所，韩国首尔。
3
    韩国首尔遣散医院延世肝脏中心。
4
    韩国首尔遣散医院延世肝脏中心。 [email protected]。
＃
    平均贡献

抽象
背景：

带有左旋肉碱的马来酸倍西福韦（BSV）是用于慢性乙型肝炎（CHB）感染的一线抗病毒药物。我们调查了BSV联合左旋肉碱是否可以改善肝脂肪变性（HS）。
方法：

首次接受抗病毒治疗（AVT）的未治疗过CHB的患者入选。使用肝脂肪变性指数（HSI）评估HS的幅度，将HS改善定义为HSI得分比基线降低≥10％。
结果：

研究患者的平均年龄为56岁，男性占多数（n = 178，64.7％）。平均体重指数（BMI），天冬氨酸转氨酶（AST），丙氨酸转氨酶（ALT）和血小板计数分别为23.5 kg /m²，49.6 IU / L，49.0 IU / L和191.3×10⁹/ L。平均HSI和纤维化（FIB）-4指数分别为32.6和0.5。 AVT治疗6个月后，血小板计数（平均191.3→167.0×10⁹/ L），空腹血糖（平均113.1→105.9 mg / dL），AST（平均49.6→28.0 IU / L），ALT（平均49.0） →33.9 IU / L），总胆固醇（平均170.0→162.1 mg / dL）水平显着降低（所有P <0.05）。在BSV组中，AST（平均95.2→30.2 IU / L）和ALT（平均81.1→31.1 IU / L）水平显着降低（均P <0.05），而HSI和FIB-4指数均保持不变（均P > 0.05）。在单变量分析中，年龄，BMI，糖尿病，肝硬化，空腹血糖水平和ALT与HS改善显着相关（所有P <0.05）。
结论：

带有左旋肉碱的BSV在CHB患者中并未显示出HS的任何改善。需要进一步的前瞻性随机对照研究来验证带有左旋肉碱的BSV在CHB感染中的潜在有益作用。

©2020韩国医学科学院。
关键字：

贝昔洛韦;恩替卡韦;肝脂肪变性；左旋肉碱；替诺福韦

PMID：
    32356416
DOI：
    10.3346 / jkms.2020.35.e104

StephenW

https://jkms.org/Synapse/Data/PDFData/0063JKMS/jkms-35-e104.pdf