重庆地区乙肝病毒基因型及抗病毒治疗与胰岛素抵抗关系的初步研究

The differences in insulin resistance among patients infected with different genotypes of the hepatitis B virus in the Chongqing area and among those before and after antiviral therapy

目的分析乙肝病毒基因型和抗病毒治疗与胰岛素抵抗的关系及临床意义。方法设计型特异引物,采用基因型特异引物聚合酶链反应(PCR)对乙肝患者进行分型,分析乙肝病毒基因型之间及抗病毒治疗前后胰岛素抵抗程度的差异。结果130例乙肝患者中,基因型B型胰岛素抵抗率为27.47%,基因型C型患者胰岛素抵抗率为28.57%,基因型B、C混合型患者胰岛素抵抗率为18.18%,未检出A、D、E、F、G、H基因型,检出的3种基因型患者间差异无统计学意义(P>0.05);54名患者抗病毒治疗后空腹血糖、胰岛素及胰岛素抵抗指数与治疗前相比差异均有统计学意义(P<0.05)。结论重庆地区乙肝患者乙肝病毒基因型与胰岛素抵抗无显著相关性;抗病毒治疗似可改善患者胰岛素抵抗。

Objective To analyze the differences in insulin resistance among patients infected with different genotypes of the hepatitis B viruses（HBV） in the Chongqing area before and after antiviral therapy. Methods Type-specific primers were designed and used to genotype the HBV strains collected in the Chongqing area using nested PCR. We then analyzed the differences in insulin resistance among patients infected with different genotypes of the HBV before and after antiviral therapy. Results Among the 130 HBV patients, the insulin resistance rate of those infected with genotype B viruses was 27.47%, with genotype C was 28.57%, and with genotype B and C was 18. 18%. No genotype A, D, E, F, G or H viruses were found in this area, and there was no statistically significance among the three different genotypes which had been found in our experiment. The degree of insulin resistance in 54 patients after antiviral therapy was lower than that of patients before antiviral therapy （P〈0.05）. Conclusion Insulin resistance did not seem to be associated with different HBV genotypes in patients in the Chongqing area, and antiviral therapy seemed to improve the patient＇s insulin resistance.