Liver steatosis and dyslipidemia after HCV eradication by direct acting antiviral agents are synergistic risks of atherosclerosis
Liver steatosis and dyslipidemia after HCV eradication by direct acting antiviral agents are synergistic risks of atherosclerosis
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DOI：
10.1371/journal.pone.0209615
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发表时间：
2018-12-21
期刊：
影响因子：
3.7
通讯作者：
Sakamoto, Naoya
中科院分区：
文献类型：
--
作者：
Kawagishi, Naoki;Suda, Goki;Sakamoto, Naoya
目的综合分析不含干扰素的直接作用抗病毒药物(DAAs)根除丙型肝炎病毒(HCV)对肝脏脂肪变性和动脉粥样硬化风险的影响。分析肝脏脂肪变性、脂代谢改变与遗传和临床因素的关系。结果共纳入117例患者。平均CAP和低密度脂蛋白胆固醇(LDL-C)水平在SVR24显著升高。然而，基线低密度脂蛋白胆固醇和CAP值与丙型肝炎病毒根除后这些值的变化呈显著负相关，这表明在基线值较高的患者中，这些值在丙型肝炎根除后普遍下降。在SVR24，平均小密度低密度脂蛋白-C(sdLDL-C)具有更大的动脉粥样硬化形成潜力，仅在血脂异常(LDL-C和GT；140 mg/dL)和肝脏脂肪变性(CAP>；248分贝/m)的患者中显著升高。这些患者的基线体重指数、低密度脂蛋白胆固醇和总胆固醇水平显著升高。结论一般来说，在基线水平较高的患者中，干扰素-脱氧核糖核酸成功根除丙型肝炎病毒可降低CAP和低密度脂蛋白胆固醇水平。然而，只有在SVR24的肝脏脂肪变性和血脂异常的患者中，低密度脂蛋白-C升高伴随sdLDL-C升高；因此，这些患者可能需要更密切的监测。
AimWe comprehensively analyzed how hepatitis C virus (HCV) eradication by interferon (IFN)-free direct-acting-antiviral-agents (DAAs) affects liver steatosis and atherogenic risk.MethodsPatients treated with IFN-free-DAAs who underwent transient elastography before and at 24-weeks post-treatment, including controlled attenuation parameter (CAP), and achieved sustained viral response (SVR) were enrolled. The association between changes in liver steatosis, lipid-metabolism, and genetic and clinical factors was analyzed.ResultsA total of 117 patients were included. The mean CAP and low-density lipoprotein cholesterol (LDL-C) levels were significantly elevated at SVR24. However, baseline LDL-C and CAP values were significantly negatively correlated with changes in these values after HCV eradication, indicating that in patients with high baseline values, the values generally decreased after HCV eradication. Mean small-dense LDL-C (sdLDL-C), which has greater atherogenic potential, was significantly elevated only in patients with both dyslipidemia (LDL-C > 140 mg/dL) and liver steatosis (CAP > 248 dB/m) at SVR24. Those patients had significant higher baseline BMI, LDL-C, and total-cholesterol levels.ConclusionsGenerally, successful HCV eradication by IFN-free-DAAs decreases CAP and LDL-C in patients with high baseline values. However, elevated LDL-C was accompanied with elevated sdLDL-C only in patients with liver steatosis and dyslipidemia at SVR24; therefore, those patients may require closer monitoring.