Effect of hepatic steatosis on the progression of chronic hepatitis B: A prospective cohort and in vitro study.
Effect of hepatic steatosis on the progression of chronic hepatitis B: A prospective cohort and in vitro study.
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肝脂肪变性对慢性乙型肝炎进展的影响：前瞻性队列和体外研究
DOI：
10.18632/oncotarget.17380
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发表时间：
2017-08-29
期刊：
影响因子：
--
通讯作者：
Ding H
中科院分区：
文献类型：
--
作者：
Chen Y;Fan C;Chen Y;Liu H;Wang S;Dong P;Li L;Ding H
目的探讨肝脏脂肪变性(HS)在慢性乙型肝炎进展中的作用。方法收集162例经肝活检证实的慢性乙型肝炎患者。所有受试者在实际的临床实践中前瞻性地随访了5年。用天冬氨酸氨基转移酶/血小板比率指数(APRI)判断肝纤维化分期。研究的终点是肝硬变、肝癌或死亡。利用油酸诱导的肝癌细胞系HepG2、HLE、PLC和SMMC-7721细胞的脂质蓄积，研究脂肪变性对肝癌细胞生物学行为的影响。结果CHB合并HS患者的平均年龄、体重指数和血清胆固醇水平均显著高于无HS患者(p<；0.05)。基线时无HS的患者APRI较低(p<；0.05)。与HS患者相比，非HS患者的APRI在随访期内显著降低(p<；0.05)。无HS组和HS组的5年累积肝硬变发生率分别为4.17%和5.19%(p>；0.05)。多因素分析显示，年龄(RR1.07，95%CI 0.996~1.149，p=0.065)和肝纤维化S3分期(RR3.50，95%CI 0.812~15.117，p=0.093)是肝硬变的危险因素。在体外，细胞脂肪变性促进了肝癌细胞的增殖和迁移，并使细胞周期处于S期。结论高龄和S3级纤维化可能是CHB合并HS患者进展为肝硬变的危险因素。HS可能加重肝脏疾病，促进肝细胞癌的进展。
Aim To characterize the effect of hepatic steatosis (HS) on the progression of chronic hepatitis B. Methods A total of 162 chronic hepatitis B (CHB) patients confirmed by liver biopsy were involved in this study. All subjects were prospectively followed-up for 5 years in real-life clinical practice. Fibrosis stage was determined using aspartate aminotransferase-to-platelet ratio index (APRI). The end-point was cirrhosis, liver cancer or death. The effects of steatosis on the biological behavior of hepatocellular carcinoma cells were investigated using oleic acid-induced lipid accumulation in HepG2, HLE, PLC, and SMMC-7721 cells. Results Mean age, body mass index, and serum cholesterol were significantly higher in CHB patients with HS than those without HS at baseline (p< 0.05). The APRI was lower in patients without HS at baseline (p<0.05). Compared to patients with HS, APRI of patients without HS decreased significantly during the follow-up period (p<0.05). The 5-year cumulative incidence of cirrhosis were 4.17% and 5.19% in patients without and with HS, respectively (p>0.05). The multivariate analysis showed that older (RR 1.07, 95% CI 0.996-1.149, p = 0.065) and S3 stage of liver fibrosis (RR 3.50, 95% CI 0.812–15.117, p=0.093) were risk factors for the progression to cirrhosis. In vitro, cell steatosis promoted proliferation and migration of HCC cells and conferred cell cycle at S phase. Conclusion The older and S3 stage of fibrosis may be risk factors for progression to cirrhosis in CHB patients with HS. HS may aggravate liver disease, promoting HCC progression.
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作者：
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DOI：
10.3760/cma.j.issn.1007-3418.2012.04.012
发表时间：
2012-04-01
影响因子：
--
作者：
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