慢性丙型肝炎合并2型糖尿病患者HCV载量与糖代谢指标的相关性分析

Correlation between HCV Load and Glucose Metabolism in Chronic Hepatitis C Patients with Type 2 Diabetes

【目的】探讨慢性丙型肝炎(CHC)合并2型糖尿病(T2DM)患者丙型肝炎病毒(HCV)载量与糖代谢指标的相关性。【方法】选取2019年3月至2021年2月本院收治的98例CHC合并T2DM患者(合并组)、76例单纯CHC患者(CHC组),另外选取在本院体检的80例健康志愿者为对照组,比较三组临床资料、糖代谢指标。将CHC合并T2DM患者依据HCV载量的不同分为病毒阴性组、低病毒载量组、中病毒载量组和高病毒载量组四个亚组,比较不同HCV载量的CHC合并T2DM患者糖代谢指标水平;采用Pearson相关性分析CHC合并T2DM患者HCV载量与糖代谢指标的关系。【结果】三组体重指数(BMI)及总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平比较,差异有统计学意义(P<0.05);合并组BMI及TC、LDL-C水平高于CHC组和对照组(P<0.05)。三组空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)和空腹胰岛素(FINS)水平比较,差异有统计学意义(P<0.05);合并组FPG、2hPG、HbA1c和FINS水平均高于CHC组和对照组(P<0.05)。不同HCV载量CHC合并T2DM患者FPG、2hPG、HbA1c和FINS水平比较,差异有统计学意义(P<0.05);低病毒载量组、中病毒载量组和高病毒载量组FPG、2hPG、HbA1c和FINS水平均高于病毒阴性组(P<0.05);高病毒载量组FPG、2hPG、HbA1c和FINS水平又均高于低病毒载量组和中病毒载量组(P<0.05)。CHC合并T2DM患者HCV载量与2hPG、FINS水平无相关性(P>0.05),与FPG、HbA1c水平均呈正相关(P<0.05)。【结论】相比单纯CHC患者和健康者,CHC合并T2DM患者糖代谢存在明显异常,且CHC合并T2DM患者HCV载量与FPG、HbA1c存在一定的相关性。

【Objective】To investigate the correlation between hepatitis C virus(HCV)load and glucose metabolism in patients with chronic hepatitis C(CHC)and type 2 diabetes(T2DM).【Methods】From March 2019 to February 2021,98 patients with CHC and T2DM(combined group)and 76 patients with simple CHC(CHC group)admitted to our hospital were selected.In addition,80 healthy volunteers who underwent physical examination in our hospital were selected as the control group,and the clinical data and glucose metabolism indicators of the three groups were compared.The patients with CHC and T2DM were divided into four subgroups according to the different HCV loads:virus negative group,low viral load group,medium viral load group,and high disease load group.The levels of glucose metabolism indicators in CHC and T2DM patients with different HCV loads were compared;Pearson correlation was used to analyze the relationship between HCV load and glucose metabolism indicators in patients with CHC and T2DM.【Results】There were significant differences in body mass index(BMI),total cholesterol(TC),and low density lipoprotein cholesterol(LDL-C)levels among the three groups(P<0.05);The levels of BMI,TC,LDL-C in the combined group were higher than those in the CHC group and the control group(P<0.05).The levels of fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),and fasting insulin(FINS)in the three groups were significantly different(P<0.05);The levels of FPG,2hPG,HbA1c,and FINS in the combined group were higher than those in the CHC group and the control group(P<0.05).The levels of FPG,2hPG,HbA1c,and FINS in patients with CHC and T2DM with different HCV loads were significantly different(P<0.05);The levels of FPG,2HPG,HbA1c,and FINS in the low viral load group,the medium viral load group,and the high viral load group were higher than those in the virus negative group(P<0.05);The levels of FPG,2hPG,HbA1c,and FINS in the high viral load group were higher than those in the low viral load group and the medium viral load group(P<0.05).In patients with CHC and T2DM,HCV load was not correlated with 2hPG and FINS levels(P>0.05),but was positively correlated with FPG and HbA1c levels(P<0.05).【Conclusion】Compared with CHC patients and healthy individuals,glucose metabolism in patients with CHC and T2DM is significantly abnormal,and there is a certain correlation between HCV load and FPG,HbA1c in patients with CHC and T2DM.