Kronik Hepatit B enfeksiyonu açlık kan şekeri düzeylerini ve yağlı karaciğeri etkiler mi?

Abstract

Amaç: Hepatit B virüsü (HBV) enfeksiyonu ile insülin direnci (ID) arasındaki ilişki kafa karıştırıcı görünmektedir. Bu çalışmada amaç, kronik aktif HBV enfeksiyonu olan hastalarda açlık kan şekeri (AKŞ) düzeyleri ile yağlı karaciğer (YK) sıklığını ID'nin bir yansıması olarak karşılaştırmak ve karaciğer fibrozunun AKŞ ve YK ile bir ilişkisi olup olmadığını belirlemekti.
Yöntemler: Bu çalışma vaka kontrol çalışması olarak planlandı. Çalışma grubu, 2000 IU/ml'nin üzerinde HBV DNA seviyesi olan 116 kronik HBV hastasından oluşturuldu. Yaş, cinsiyet ve vücut kitle indeksi uyumlu 120 sağlıklı bireyden bir kontrol grubu oluşturuldu.
Bulgular: Gruplar arasında AKŞ düzeyleri arasında fark yoktu (P=0,15), HBV'li hastalarda YK oranları anlamlı olarak daha yüksekti (P=0,01; OR: 2,13, %95 GA 1,26-3,61). Fibrozis şiddetine göre gruplar arasında AKŞ düzeyleri arasında anlamlı bir fark olmamasına rağmen, YK açısından anlamlı bir fark vardı (sırasıyla P=0,07 ve P<0,001). YK gelişimi ile fibrozisin şiddeti arasında pozitif bir korelasyon bulundu (rs=0,216, P=0,01).
Sonuç: AKŞ düzeyi kronik aktif HBV enfeksiyonundan etkilenmemiş gibi görünse de, bu hastalarda YK sıklığı belirgin şekilde artmaktadır. Metabolik faktörlerden ziyade viral faktörlerin YK gelişiminden sorumlu olması muhtemeldir.

Keywords

• Yağlı karaciğer,Hepatit B,İnsülin direnci,NAFLD

Does chronic hepatitis B infection have an impact on fasting blood glucose levels and fatty liver development?

Abstract

Aim: The relationship between hepatitis B virus (HBV) infection and insulin resistance (IR) appears to be confusing. In this study, the goal was to compare fasting blood glucose (FBG) levels and fatty liver (FL) frequency as a reflection of IR in patients with chronic active HBV infection and to determine whether there is a relationship between liver fibrosis, FBG and FL.
Methods: In this case-control study, the study group consisted of 116 chronic HBV patients with HBV DNA levels above 2000 IU/ml. The control group included 120 healthy individuals with matching age, gender, and body mass indexes.
Results: There was no difference in FBG levels between the groups (P=0.15), but FL rates were significantly higher in patients with HBV (P=0.01; OR: 2.13, 95% CI 1.26-3.61). Although the FBG levels of groups with regards to severity of fibrosis were similar, there was a significant difference in terms of FL (P=0.07 and P<0.001, respectively). A positive correlation was found between the development of FL and the severity of fibrosis (rs=0.216, P=0.01).
Conclusion: While FBG level appears to be unaffected by chronic active HBV infection, the frequency of FL is markedly increased in these patients. Viral factors are likely responsible for the development of FL rather than metabolic factors.

Keywords

• Fatty liver,Hepatitis B,Insulin resistance,NAFLD

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