Relations of hepatic steatosis with liver functions, inflammations, glucolipid metabolism in chronic hepatitis B patients.
Ключови думи
Резюме
OBJECTIVE
To investigate the relations between the steatosis and liver functions, inflammations, and glucolipid metabolism in chronic hepatitis B patients.
METHODS
A total of 144 chronic hepatitis B patients who were admitted to our hospital from January 2015 to April 2017 were selected and divided into the steatosis group (n=73) and the non-steatosis group (n=71) according to the detection of hepatic puncture biopsy. The general information of the patients including age, sex, and body mass index (BMI) was collected, and patients' liver functions, inflammations, and glucolipid metabolism indicators were determined and compared between the chronic hepatitis patients with steatosis and without steatosis. The chronic hepatitis patients with steatosis were further divided into the normal group and the abnormal group based on the level of C-reactive protein (CRP) (8 mg/L). Besides, according to the level of aspartate aminotransferase (AST), these patients were divided into the normal liver function group (AST<40 U/L) and the abnormal liver function group (AST>40 U/L), among whom the hepatic steatosis, glucolipid metabolism, and inflammations were compared. At the same time, the chronic hepatitis B patients with steatosis were divided into Group F1, Group F2, and Group F3 based on the fatty degeneration grade, the correlations of steatosis with inflammations, glucolipid metabolism, and liver functions were analyzed. At last, the regression analyses between steatosis and the inflammation grade, glucolipid metabolism and liver function indicators were conducted for Group F1, F2, and F3, respectively.
RESULTS
In the chronic hepatitis B patients with steatosis, liver function indicators-alanine aminotransferase (ALT) and AST, levels of inflammatory factors-interleukin-2 (IL-2), IL-6 and CRP and glucolipid metabolism indicators-fasting blood glucose (FBG), 2h postprandial blood glucose (2h PBG), fasting insulin (FINS), triacylglycerol (TG), total cholesterol (TC), and low-density lipoprotein (LDL) were significantly higher than those without steatosis (p<0.05). The steatosis, liver functions, and glucolipid metabolism indicators were statistically different between patients in the normal inflammatory factor group and the abnormal inflammatory factor group (p<0.06). In addition, the liver function indicators (ALT and AST) and glucolipid metabolism indicators (FBG, 2h PBG, FINS, TG, TC, HDL, and LDL) in the abnormal group were statistically higher than those of normal inflammatory factor group (p<0.05). In the normal liver function group, the average fatty degeneration grade was statistically lower than that in the abnormal liver function group (p<0.05), and glucolipid metabolism indicators (FBG, 2h PBG, FINS, TG, TC, IL-2, IL-6, CRP, HDL, and LDL) were also markedly lower than those in the abnormal liver function group (p<0.05). The steatosis was positively correlated with relevant indicators, including the blood glucose indicator of FBG (r=0.509, p<0.05), liver function indicator of AST (r=0.602, p<0.05), the blood lipid indicator of TG (r=0.740, p<0.05), and the inflammatory factor of CRP (r=0.882, p<0.05), respectively. The disease course, BMI, 2h FBG, FINS, TG, TC, HDL, LDL, AST, ALT, and inflammatory factors of IL-2, IL-6, and CRP were involved in risk factors of steatosis (p<0.05).
CONCLUSIONS
Our data demonstrates that the steatosis is correlated with liver functions, glucolipid metabolism and inflammation level in chronic hepatitis B patients, and the foregoing indicators can affect the disease development of chronic hepatitis B patients with steatosis.
