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.

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.

Serum 25-hydroxyvitamin deficiency in middle-aged a cross-sectional study D levels and testosterone Korean men：

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.