慢性丙型肝炎合并非酒精性脂肪肝血清尿酸与病毒及代谢的相关分析

Correlation analysis of viral and metabolism associated with serum level of uric acid in patients with chronic hepatitis C complicated with nonalcoholic fatty liver disease

目的探讨慢性丙型肝炎(CHC)合并非酒精性脂肪肝(NAFLD)尿酸水平与病毒和代谢因素的相关性。方法选择98例初次就诊且未行抗病毒治疗的CHC,根据是否伴NAFLD分为CHC合并NAFLD组45例和单纯CHC组53例。检测2组尿酸水平,并比较其水平与丙型肝炎病毒、血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、体质量指数(BMI)、空腹血糖(FBS)、空腹胰岛素水平(NS)、甘油三酯(TG)、总胆固醇(TC)及胰岛素抵抗指数(HOMA-IR)等的相关性。结果 CHC合并NAFLD组BMI、尿酸、TG、TC、FBS、NS及HCVRNA载量较单纯CHC组明显升高(P<0.05)。相关性及回归分析表明,尿酸同BMI、FBS、NS、TG、HOMA-IR及HCVRNA载量明显呈正相关,与ALT、AST无相关性。结论 CHC并发NAFLD与患者血清尿酸水平升高密切相关,与丙肝病毒因素相关。合并脂肪变的慢性丙型肝炎患者病毒栽量与尿酸水平升高及胰岛素抵抗相关。

Objective To investigate the viral and metabolic factors associated with serum level of Uric acid in patients with chronic hepatitis C （CHC） complicated with nonalcoholic fatty liver disease （NAFLD）. Methods A total of 98 patients who were not treated with CHC at the first visit in our hospital were divided into two groups according to diagnosis combined with NAFLD, 45 patients combined with NAFLD in group A and 53 patients without NAFLD in group B. The levels of Uric acid of the two groups were detected and the con＇elated comparison was made with Hepatitis C virus, serum alanine transaminase （ALT）, aspartate trans-aminase （AST）, body- mass index （BMI）, fasting plasma glucose （FBS）, Fasting insulin （NS）, triglyceride （TG）, cholesterol （TC） and homeostatic model assessment of insulin resi- stance （HOMA-IR）. Results The Uric acid, TG, TC, FBS, NS, HOMA-IR, BIM, hepatitis virus C （HCV） Ribonu- cleic acid （RNA） of group A was significantly higher than that of group B. Partial correlation analysis showed that Uric acid was positively correlated to BMI, HCVRNA, TG, TC, FBS, NS and HOMA-IR. Conclusion The catabatic level of Uric acid is closely eorrelatecl with patients＇ CHC ancl NAFLD, ancl eorrelatecl to viruses factors, too.