Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection
Insulin resistance is associated with hepatocellular carcinoma in chronic hepatitis C infection
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DOI：
10.3748/wjg.v16.i18.2265
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发表时间：
2010-05-14
影响因子：
4.3
通讯作者：
Lee, Chuan-Mo
中科院分区：
文献类型：
--
作者：
Hung, Chao-Hung;Wang, Jing-Houng;Lee, Chuan-Mo
目的：探讨胰岛素抵抗（IR）和血清脂联素水平在慢性丙型肝炎合并肝细胞癌（HCC）中的作用。方法：收集165例初诊HCC患者的临床和生化资料。对188例不同阶段丙型肝炎病毒（HCV）感染者的胰岛素抵抗（HOMA-IR）和血清脂联素水平进行了研究与B肝炎病毒（HBV; 12.7%，n = 63）或非HBV、非HCV病例（7.1%，n = 28）相比，（35.6%，n = 59）。在慢性丙型肝炎患者中，HCC患者的血糖（P < 0.001）、胰岛素水平（P = 0.003）和HOMA-IR（P = 0.018）高于慢性肝炎和晚期肝纤维化患者。年龄、男性、体重指数与血清脂联素水平显著相关，而HOMA-IR与血清脂联素水平无关。基于逐步logistic回归分析，年龄（OR：1.124，P < 0.001），血清胰岛素水平（OR：1.585，P < 0.001），HOMA-IR（OR：0.495，P = 0.001）、糖尿病（OR：11.601，P = 0.002）和男性（OR：3.877，P = 0.016）与肝癌独立相关。这一结果是相似的，即使糖尿病受试者被排除在analysis.CONCLUSION：HOMA-IR测量的胰岛素抵抗，无论是否存在糖尿病，是显着相关的慢性HCV感染患者的肝癌发展。(C)2010年百世登。All rights reserved.
AIM: To elucidate the role of insulin resistance (IR) and serum adiponectin level in hepatocellular carcinoma (HCC) associated with chronic hepatitis C.METHODS: Clinical and biochemical characteristics were collected from 165 consecutive patients with newly diagnosed HCC. Homeostasis model assessment of IR (HOMA-IR) and serum adiponectin level were investigated in 188 patients with different stages of hepatitis C virus (HCV) infection.RESULTS: Among HCC patients, type 2 diabetics (DM) was more prevalent in HCV subjects (35.6%, n = 59) compared to hepatitis B virus (HBV; 12.7%, n = 63) or non-HBV, non-HCV cases (7.1%, n = 28). In patients with chronic hepatitis C, HCC subjects had higher blood sugar (P < 0.001), insulin level (P = 0.003) and HOMA-IR (P = 0.018) than those with chronic hepatitis and advanced fibrosis. Age, male sex and body mass index were significantly associated with serum adiponectin level, whereas HOMA-IR was not. Based on stepwise logistic regression analysis, age (OR: 1.124, P < 0.001), serum insulin level (OR: 1.585, P < 0.001), HOMA-IR (OR: 0.495, P = 0.001), DM (OR: 11.601, P = 0.002) and male sex (OR: 3.877, P = 0.016) were independently associated with HCC. This result was similar even if the diabetic subjects were excluded for analysis.CONCLUSION: Insulin resistance measured by HOMA-IR, regardless of the presence of diabetes, is significantly associated with HCC development in patients with chronic HCV infection. (C) 2010 Baishideng. All rights reserved.