Serum apolipoprotein C-III is independently associated with chronic hepatitis C infection and advanced fibrosis
Serum apolipoprotein C-III is independently associated with chronic hepatitis C infection and advanced fibrosis
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DOI：
10.1007/s12072-011-9291-x
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发表时间：
2012-04-01
影响因子：
6.6
通讯作者：
Patel, K.
中科院分区：
文献类型：
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作者：
Rowell, J.;Thompson, A. J.;Patel, K.
背景 已知丙型肝炎病毒 (HCV) 会破坏脂质代谢，使血清脂蛋白水平成为 HCV 疾病进展标志物的良好候选者。主要载脂蛋白 (Apo) 的评估及其与肝纤维化的关系在很大程度上仍未得到探索。 方法 我们比较了清除与活动性感染患者 (n = 83) 以及慢性感染患者 (n = 216）使用多元逻辑回归对晚期肝纤维化与轻中度肝纤维化（METAVIR F3-4 期与 F0-2 期）进行比较。 结果 感染清除的受试者与活动性感染受试者相比，Apo C-III 水平高出 25% (p = 0.009)。单变量中，低水平的 Apo C-III (p = 1.3 9 10(-5))、Apo A-I (p = 2.9 9 10(-5))、总胆固醇 (p = 5.0 9 10(-4))、LDL-C (p = 0.005) 和 HDL-C (p = 2.0 9 10(-4)) 与晚期纤维化相关分析。多变量分析显示 Apo C-III 是与晚期纤维化相关的最重要因素 (p = 0.0004)，其次是年龄 (p = 0.013) 和 Apo A-I (p = 0.022)。将 Apo C-III 和 Apo A-I 纳入预测晚期纤维化的模型中，仅略微改善了受试者工作曲线下面积。 结论 相对于其他脂蛋白，低血清 Apo C-III 水平与慢性感染和清除感染的相关性最强，并且随着肝纤维化严重程度的增加而下降。 Apo C-III 作为 HCV 疾病进展的可能标志值得进一步关注。
Background The hepatitis C virus (HCV) is known to disrupt lipid metabolism, making serum lipoprotein levels good candidates to explore as markers of HCV disease progression. Assessment of the major apolipoproteins (Apo) and their relationship to hepatic fibrosis remain largely unexplored.Methods We compared the levels of total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), and Apo A-I, -B, -C-III, and -E between patients with cleared versus active infection (n = 83), and between those chronically infected patients (n = 216) with advanced versus mild-moderate hepatic fibrosis (METAVIR stage F3-4 vs. F0-2) using multiple logistic regression.Results Apo C-III levels were 25% higher in subjects with cleared infection versus those with active infection (p = 0.009). Low levels of Apo C-III (p = 1.3 9 10(-5)), Apo A-I (p = 2.9 9 10(-5)), total cholesterol (p = 5.0 9 10(-4)), LDL-C (p = 0.005), and HDL-C (p = 2.0 9 10(-4)) were associated with advanced fibrosis in univariate analyses. Multivariable analysis revealed Apo C-III as the most significant factor associated with advanced fibrosis (p = 0.0004), followed by age (p = 0.013) and Apo A-I (p = 0.022). Inclusion of both Apo C-III and Apo A-I in a model to predict advanced fibrosis improved the area under the receiver operator curve only modestly.Conclusions Relative to other lipoproteins, low serum Apo C-III levels are the most strongly associated with chronic versus cleared infection and decline with increasing severity of hepatic fibrosis. Apo C-III deserves further attention as a possible marker of HCV disease progression.