Association of chronic viral hepatitis B with insulin resistance

AIM:To investigate the relationship between chronic viral hepatitis B(CVHB) and insulin resistance(IR) in Korean adults.METHODS:A total of 7880 adults(3851 men,4029 women) who underwent a comprehensive medical examination were enrolled in this study.Subjects diagnosed with either diabetes mellitus,or any other disorder that could influence their insulin sensitivity,were rejected.Anthropometry,metabolic risk factors,hepatitis B surface antigen,hepatitis B surface antibody,hepatitis B core antibody,fasting plasma glucose and insulin were measured for all subjects.Homeostasis model assessment(HOMA),quantitative insulin check index(QUICKI),and Mf fm index were used for determining insulin sensitivity.Each participant was categorized into a negative,recovery,or CVHB group.To compare variables between groups,a t-test and/or one-way analysis of variance were used.Partial correlation coefficients were computed to present the association between insulin resistance and other variables.Multiple logistic regression analysis was used to assess the independent association between CVHB and IR.RESULTS:The mean age of men and women were 48.9 and 48.6 years,respectively.Subjects in the CVHB group had significantly higher waist circumference [(86.0 ± 7.7 cm vs 87.3 ± 7.8 cm,P = 0.004 in men),(78.3 ± 8.6 cm vs 80.5 ± 8.5 cm,P < 0.001 in women)],cystatin C [(0.96 ± 0.15 mg/dL vs 1.02 ± 0.22 mg/dL,P < 0.001 in men),(0.84 ± 0.15 mg/dL vs 0.90 ± 0.16 mg/dL,P < 0.001 in women)],fasting insulin [(5.47 ± 3.38 U/mL vs 6.12 ± 4.62 U/mL,P < 0.001 in men),(4.57 ± 2.82 U/mL vs 5.06 ± 3.10 U/mL,P < 0.001 in women)] and HOMA index [(1.24 ± 0.86 vs 1.43 ± 1.24,P < 0.001 in men),(1.02 ± 0.76 vs 1.13 ± 0.87,P = 0.033 in women)] compared to control group.The HOMA index revealed a positive correlation with body mass index(BMI)(r = 0.378,P < 0.001),waist circumference(r =0.356,P < 0.001),percent body fat(r = 0.296,P < 0.001),systolic blood pressure(r = 0.202,P < 0.001),total cholesterol(r = 0.134,P < 0.001),triglycerides(r = 0.292,P < 0.001),cystatin C(r = 0.069,P < 0.001) and uric acid(r = 0.142,P < 0.001).The QUICKI index revealed a negative correlation with BMI(r =-0.254,P < 0.001),waist circumference(r = 0-0.243,P < 0.001),percent body fat(r =-0.217,P < 0.001),systolic blood pressure(r =-0.132,P < 0.001),total cholesterol(r =-0.106,P < 0.001),triglycerides(r =-0.205,P < 0.001),cystatin C(r =-0.044,P < 0.001) and uric acid(r =-0.096,P < 0.001).For subjects identified with IR,the odds ratio of an accompanying diagnosis of chronic hepatitis B was 1.534(95% CI:1.158-2.031,HOMA index criteria) or 1.566(95% CI:1.124-2.182,QUICKI criteria) after adjustment for age,gender,BMI,and amount of alcohol consumption.CONCLUSION:Our study demonstrates that CVHB is associated with IR.CVHB may need to be monitored for occurrence of IR and diabetes mellitus.

Effect of intra-arterial infusion with triolein emulsion on rabbit liver

AIM: To determine whether intra-arterial infusion of triolein emulsion has biochemical and histopathologic effect on rabbit liver.METHODS: An emulsion of 0.2 mL triolein in 20 mL of saline was infused into either the hepatic arteries of nine rabbits(group 1) or the superior mesenteric arteries of 12 rabbits(group 2). Five rabbits infused with 20 mL of normal saline were used as a control group(group 3). The serum aspartate aminotransferase(AST) and alanine aminotransferase(ALT) levels were measured to evaluate liver function in each group just before the infusion, at 2 h, day 1, day 4, and day 7 following infusion. Each rabbit in all of the groups was infused with Evans blue on day 7 to evaluate changes in vascular permeability, and obtain the stained area of the hepatic surface. If the stained area was not available, the anteroinferior portion of the right hepatic lobe was selected. The obtained tissues were examined by light, electron and confocal microscopy. The changes in AST and ALT levels at each time point were calculated and statistically analyzed using a mixed linear model. A P value < 0.05 was regarded as statistically significant. RESULTS: In group 1(hepatic artery group), both the AST and ALT serum levels increased significantly on day 1(P = 0.0016 and P < 0.0001, respectively) compared with the control group, followed by a decrease thereafter. In group 2(portal vein group), the AST level increased on day 4(P = 0.0095), while the ALT level increased significantly on day 1(P < 0.0001), and decreased thereafter, as compared with the control. For the remainder of the examination days, there were no significant changes in the AST and ALT levels(P > 0.05). Only three rabbits in each group showed hepatic surface staining with the Evans blue dye. Light and electron microscopic findings showed no specific changes in the selected hepatic tissues. Confocal microscopic examination with transferase-mediated dUTP nick-end labeling stain revealed lack of hepatocyte apoptosis in any of the groups. There were no differences in the results between group 1 and group 2.CONCLUSION: Infusion of triolein emulsion into rabbit livers revealed a minimal transient decrease of liverfunction,and no specific histopathologic changes.

Triolein emulsion infusion into the hepatic artery increases vascular permeability to doxorubicin in rabbit liver

BACKGROUND The infusion of triolein emulsion(TE)induced increased vascular permeability and a negligible and temporary decrease in liver function without specific histopathological damage.AIM To assess changes in doxorubicin concentration according to the percentage of TE infused via a hepatic artery to study the vascular permeability in the rabbit liver.METHODS Thirty-nine healthy rabbits were divided into five groups according to the concentration of emulsified triolein infused into the hepatic arteries:Group 0,saline infusion(control group,n=5);group 1,0.3%TE(n=13);group 2,0.6%TE(n=6);group 3,0.9%TE(n=8);and group 4,1.5%TE(n=6).Doxorubicin(2.4 mg/kg)was infused immediately after TE injection via the hepatic arteries.After 2 h,the livers were harvested,and doxorubicin concentrations were calculated fluorometrically.The doxorubicin concentrations were compared between TE groups and the control group,and the optimal concentrations within the TE groups were calculated.Statistical analysis was performed using the nonparametric Mann-Whitney U test and Kruskal-Wallis test.P<0.05 were considered statistically significant.RESULTS In the liver,doxorubicin concentrations were 2.06,2.07,2.16 and 1.66 times higher in groups 1 through 4,respectively,and significantly higher in the TE groups than in the control group(all P<0.05).However,there were no significant differences in the mean doxorubicin concentrations between the four TE groups(P=0.642).In the lungs,the mean doxorubicin concentrations were not significantly different between the control and TE groups(P>0.05).CONCLUSION TE infusion into the hepatic arteries significantly increased the doxorubicin concentration approximately twofold but was not different between the TE groups.These findings suggest that TE infusion might be a useful adjuvant treatment of liver cancers.

韩国中年男性血清25-羟维生素D水平与皋酮缺乏：一项横向研究

Previous studies have demonstrated that male hypogonadism is associated with a low level of vitamin D. However, no reports have investigated the effects of vitamin D on testosterone levels in Korean men. Our aim was to investigate whether testosterone levels are associated with serum vitamin D levels and whether seasonal variation exists. This cross-sectional study analyzed serum 25-hydroxyvitamin D [25（OH）D], total testosterone （TT）, and free testosterone （FT） in 652 Korean men over 40 years of age who had undergone a comprehensive medical examination. The average age of the subjects was 56.7± 7.9 years, and the mean serum 25（OH）D, TT and FT levels were 21.23 ± 7.9 ng m1-1, 4.70 ±1.6 ng m1-1, and 8.12± 3.3 pg m1-1, respectively. In the multiple linear regression model, 25（OH）D showed positive association with TT （β =0.137, P〈 0.001） and FT （p =0.103, P= 0.008）. 25（OH） D and FT showed similar seasonal or monthly variation after adjustment for age. A vitamin D deficiency [25（OH）D 〈 20 ng m1-1] was associated with an increased risk of deficiencies of TT （〈2.30 ng ml-1） （odds ratio [OR]： 2.65; 95% confidence interval [CI]. 1.21-5.78, P = 0.014） and FT （〈6.50 pg ml-1） （OR： 1.44; 95% Ch 1.01-2.06 P = 0.048） after adjusting for age, season, body mass index, body composition, chronic disease, smoking, and alcohol use. In conclusion, we demonstrated a positive correlation between 25（OH）D and testosterone, which showed similar seasonal variation in Korean men.