血清脂联素水平与慢性乙型肝炎患者伴发代谢综合征的相关性研究

Adiponectin and its receptors in chronic hepatitis B patients with metabolic syndrome

目的研究脂联素及其受体2与慢性乙型肝炎感染伴发MS患者的肝脂肪变、纤维化和炎症的相关性。方法收集138例慢性乙型肝炎（chronichepatitisB，CHB）患者资料，根据患者有无代谢综合征（metabolicsyndrome，MS）分为MS组（65例）和非Ms组（73例），检测两组患者血清脂联素（adiponectin，Adi）水平，并比较血清酶学、糖脂类代谢相关指标水平以及HBeAg阳性率等指标是否有组间差异。结果CHB伴发MS患者血清酶学、糖脂类代谢相关指标水平以及HBeAg阳性率明显高于非MS组。体重指数和稳态模型评估指数是CHB伴发MS患者的独立危险因素。结论CHB患者伴发的MS与胰岛素抵抗相关，肝脏脂联素表达水平与CHB伴发MS患者疾病进展密切相关。

Objective To assess the relationship between adiponectin, its receptors and hepatic steatosis, firosis, inflmmation in patients of chronic hepatitis B （CHB） with metabolic syndrome （MS）. Methods We studied 138 patients with chronic hepatitis B （CHB）, who were from Beijing Ditan hospital from January 2005 to December 2012. According to whether being diagnosd with MS, two groups （65 with MS vs 73 without MS） were established. They were compared with demographic, biochemical, metabolic, and histological characteristics. The serum adiponectin level of patients were detected. Results In the group of CHB patients with MS, the levels of LDH, γ-GT, FPG, FINS, HOMA-IR, HOMA-β, TG, and HBeAg positive rate were significantly higher than those in the group without MS. With binary logistic regres- sion analyses, BMI and HOMA-IR showed independent predictors to MS in patients with CHB. Conclusions The CHB patients with MS showed more severe steatosis, CHB showed insulin resistance. Reduced serum levels of adiponectin might be relevance in CHB patients with MS. These findings indicated that reduced liv- er adiponectin expression may play an important role in the pathogenesis and progression of CHB patients with MS.