慢性丙型肝炎患者肝细胞胰岛素受体的表达

Expression of Insulin Receptor in Patients with Chronic Hepatitis C Virus Infection

目的研究胰岛素受体在慢性丙型肝炎患者肝细胞的表达情况。方法选取27名慢性丙型肝炎患者,依照病理诊断分为轻度(F0)、中度(F1-2)、重度(F3-4)3组进行临床生化检测,同时取肝组织提取RNA,反转录为cDNA,利用实时荧光定量PCR检测肝组织胰岛素受体(insulin receptor,INSR)mRNA水平,分析肝组织不同病理分级时INSR的表达及临床生化指标的变化。结果随着肝组织病理分级的加重,丙氨酸氨基转移酶(alanine transam inase,ALT)、天冬氨酸转移酶(aspartate transam inase,AST)及胆红素变化的差异无统计学意义,而空腹血糖、餐后2h血糖、糖化血红蛋白增高,胆碱酯酶(cholineste rase,CHE)及胰岛素受体(INSR)的表达下降。若以F0组INSR的表达量为100%,则F1-2组INSR的表达为78.8%,F3-4组为30%。结论胰岛素受体的表达随肝脏纤维化的增加而减少,Ⅱ型糖尿病发病率升高。

Objective To observe insulin receptor （INSR） expression in patients with chronic hepatitis C virus（HCV） infection. Methods Twenty-seven patients with chronic hepatitis C were selected,and a liver biopsy was performed at the baseline. These patients were divided into 3 groups based on pathological classification（METAVIR fibrosis stage F0,n=8; F1-2,n=15; F3-4,n=4）. Clinical routine biochemical parameters were examined. Liver tissue total RNAs were extracted and prepared with a commercial kit,then cDNAs were synthesized and real-time fluorescent quantitative PCR was used to analyze the expression of INSR of patients from the 3 different groups. Results Alanine transaminase（ALT）,aspartate transaminase（AST） and bilirubin（BIL） had no change in the patients of the 3 groups,but fasting blood glucose（FBG）,2-hour postprandial blood glucose（PBG）,glycohemoglobin increased,and cholinesterase（CHE）,INSR expression decreased when METAVIR fibrosis stage rose. Compared with F0 group,INSR expression of F1-2 group was 78.8%,and that of F3-4 group was 30% of the value of F0 group. Conclusion Expression of INSR decreases,and the morbidity of type 2 diabetes mellitus increases with the advancing of METAVIR fibrosis stage in patients with chronic HCV infection.