An assessment of serum leptin levels in patients with chronic viral hepatitis: a prospective study.
An assessment of serum leptin levels in patients with chronic viral hepatitis: a prospective study.
复制标题
DOI：
10.1186/1471-230x-7-17
复制
发表时间：
2007-05-31
影响因子：
2.4
通讯作者：
Theocharis S
中科院分区：
文献类型：
--
作者：
Manolakopoulos S;Bethanis S;Liapi C;Stripeli F;Sklavos P;Margeli A;Christidou A;Katsanika A;Vogiatzakis E;Tzourmakliotis D;Theocharis S
瘦素在慢性病毒性肝炎（CVH）引起的肝病过程中的作用仍存在争议。我们的目的是调查血清瘦素浓度与肝病严重程度之间的关系，在一个队列的HBeAg阴性的慢性乙型肝炎B（CH B）和丙型肝炎（CHC）的受试者，并分析身体成分，瘦素系统和胰岛素抵抗以及病毒因素对抗病毒治疗的病毒学应答的影响。我们研究了50例（36名男性）连续患者，活检证实CVH由于HBV（n = 25）或HCV（n = 25）感染。32名（17名男性）健康志愿者作为对照。在治疗前和治疗结束时，通过免疫测定法测定血清瘦素和胰岛素水平。血清瘦素水平与肝纤维化分期显著相关;肝硬化患者血清瘦素水平高于肝纤维化分期较低的患者[CHB患者（17436 pg/ml vs 6028.5 pg/ml，p = 0.03），CHC患者（18014 pg/ml vs 4385 pg/ml，p = 0.05）]。在慢性乙型肝炎患者中，较低的瘦素水平和对拉米夫定单药治疗的反应之间呈负相关;病毒学应答者的血清瘦素水平低于无应答者（5334 vs 13111.5 pg/ml; p值= 0.003）。在基因1型CHC患者中，胰岛素抵抗在抗病毒治疗的反应中起重要作用。我们的数据清楚地表明，CHB或CHC引起的肝硬化与较高的瘦素水平相关。血清瘦素水平升高是慢性乙型肝炎患者拉米夫定单药治疗反应的一个负性预后因素。在CHC患者中，胰岛素抵抗强烈影响基因1型感染患者对抗病毒治疗的反应。
The role of leptin in the course of liver disease due to chronic viral hepatitis (CVH) remains controversial. Our aims were to investigate the relationship between serum leptin concentrations and the severity of liver disease in a cohort of subjects with HBeAg negative chronic hepatitis B (CHB) and C (CHC) and to analyze the effect of body composition, the leptin system and insulin resistance together with viral factors on virologic response to antiviral treatment. We studied 50 (36 men) consecutive patients suffering from biopsy-proven CVH due to HBV (n = 25) or HCV (n = 25) infection. Thirty-two (17 men) healthy volunteers served as controls. Levels of serum leptin and insulin were determined by immunoassays at baseline and at the end of the treatment. A significant association between serum leptin levels and the stage of hepatic fibrosis was noted; patients with cirrhosis presented higher serum leptin levels compared to those with lower fibrosis stage [CHB patients (17436 pg/ml vs 6028.5 pg/ml, p = 0.03), CHC patients (18014 pg/ml vs 4385 pg/ml, p = 0.05]. An inverse correlation between lower leptin levels and response to lamivudine monotherapy was noted in patients with CHB; those with a virologic response presented lower serum leptin levels (5334 vs 13111.5 pg/ml; p-value = 0.003) than non-responders. In genotype 1 CHC patients, insulin resistance played a significant role in the response to antiviral therapy. Our data clearly suggest that cirrhosis due to CHB or CHC is associated with higher leptin levels. Increased serum leptin levels represent a negative prognostic factor for response to lamivudine monotherapy in patients with CHB. In CHC patients insulin resistance strongly influences the response to antiviral treatment in patients infected with genotype 1.