2型糖尿病患者乙型肝炎病毒感染率分析

Seroprevalence of hepatitis B virus infection in Chinese patients with type 2 diabetes mellitus

目的:通过调查糖尿病患者乙型肝炎病毒(HBV)的携带率,阐明糖尿病发生是否与HBV感染有关,并观察糖尿病合并HBV感染时是否加重对肝功能的损害。方法:用ELISA方法检测533例2型糖糖尿病患者和1440例普通人群乙型肝炎表面抗原(HBsAg)以及HBV其他血清学标志,同时常规测定肝功能和血糖等。结果:2型糖尿病HBsAg阳性24例,阳性率4.50%,普通人群HBsAg阳性70例,阳性率4.86%,两组间阳性率差异无统计学意义(x2=0.110,P=0.740)。糖尿病患者感染HBV后的抗体应答与普通人群相似。糖尿病合并HBV感染者与无糖尿病HBV感染者的肝功能异常差异无统计学意义。糖尿病患者中83例(16.3%)谷氨酰转肽酶升高,在肝功能异常指标中最常见,这与HBV感染后丙氨酸转氨酶升高为主不同。结论:糖尿病发生与HBV感染无关,糖尿病合并HBV感染时不加重对肝脏的损害。

Objective： To clarify the role of hepatitis B virus （HBV） infection in the pathogenesis of diabetes mellitus （DM） by investigating the prevalence of HBsAg in patients with DM in China and to investigate whether infection of HBV may exacerbate hepatic injury in DM patients. Methods： ELISA was used to detect HBsAg and other serologic markers for HBV infection in sera of 533 type 2 DM patients and of 1440 general persons. Liver functions and blood glucose were conventionally tested. Results： HBsAg was detected in 24 （4.50%） of the DM patients and 70 （4.86%） of the general persons. The difference of the positive rates in these two groups had no statistical significance （x^2=-0.110, P=0.740）. The pattern of antibody responses to HBV in the DM patients was similar to that in general persons. The liver functions in the DM patients with HBV infection were comparable to those in HBV infected general persons. Elevated gamma-glutamyl transferase occurred in 16.3% of the DM patients, which showed to be the most abnormal liver function test in the DM patients and was different from the liver dysfunction caused by HBV, in which elevation of alanine transferase is the most common. Conclusions： The data suggest that HBV infection plays little role in the pathogenesis of DM in Chinese patients. HBV infection in DM patients does not deteriorate the liver damage.