乙型肝炎病毒感染与磷脂代谢和胰岛素抵抗的相关性  

Correlation between hepatitis B virus infection and phospholipid metabolism,insulin resistance

作　　者：李婷 黄利琼 陈婵[1] 柳永刚 尹燕 LI Ting;HUANG Li-qiong;CHEN Chan;LIU Yong-gang;YIN Yan(The First Affiliated Hospital of Jinan University,Guangzhou,Guangdong 510630,China)

机构地区：[1]暨南大学附属第一医院消化内镜中心,广东广州510630 [2]暨南大学附属第一医院消化内科,广东广州510630 [3]暨南大学附属第一医院消化风湿科,广东广州510630

出　　处：《中华医院感染学杂志》2021年第17期2589-2593,共5页Chinese Journal of Nosocomiology

基　　金：广东省自然科学基金资助项目(20196897)。

摘　　要：目的探究乙型肝炎病毒(HBV)表面抗原水平与磷脂代谢和胰岛素抵抗的相关性。方法选取暨南大学附属第一医院2017年1月-2019年6月门诊423例代谢综合征患者为研究对象,以乙型肝炎表面抗原(HBsAg)和(或)HBV DNA结果分为HBV感染阳性组(n=95)和HBV感染阴性组(n=328),分析患者血清磷脂脂肪酸构成谱[饱和脂肪酸(SFA)、单不饱和脂肪酸(MUFA)、多不饱和脂肪酸(PUFA)]以及胰岛素抵抗相关指标[空腹血糖(FBG)、空腹胰岛素(FINS),胰岛素敏感指数(ISI)和胰岛素抵抗指数(HOMA-IR)],并采用Spearman分析乙型肝炎表面抗原水平与磷脂脂肪酸构成谱、胰岛素抵抗相关指标的相关性。结果HBV感染阳性组患者血清中SFA、n-6/n-3PUFA水平高于HBV感染阴性组,n-6PUFA、n-3PUFA、PUFA、PUFA/SFA水平均低于HBV感染阴性组,比较差异有统计学意义(P<0.05);HBV感染阳性组患者FBG、HOMA-IR水平高于HBV感染阴性组,FINS、ISI低于HBV感染阴性组,比较差异有统计学意义(P<0.05);Spearman相关性分析显示,HBsAg水平与SFA、n-6/n-3PUFA呈正相关,与n-3PUFA、n-6PUFA、PUFA、PUFA/SFA呈负相关,与MUFA无相关;HBsAg水平与FBG、HOMA-IR呈正相关,与FINS、ISI呈负相关。结论HBV感染可能会引起代谢综合征患者血清磷脂脂肪酸构成改变以及胰岛素抵抗。OBJECTIVE To explore the correlation between the level of hepatitis B virus(HBV)surface antigen and the phospholipid metabolism,insulin resistance(IR).METHODS A total of 423patients with metabolic syndrome who were treated in outpatient department of the First Affiliated Hospital of Jinan University from Jan 2017to Jun 2019were recruited as the study subjects and divided into the HBV infection-positive group with 95cases and the HBV infection-negative group with 328cases according to the result of HBsAg and(or)HBV DNA test.The serum phospholipid fatty acid spectrum[saturated fatty acid(SFA),monounsaturated fatty acid(MUFA),polyunsaturated fatty acid(PUFA)],insulin resistance-related indexes fasting blood glucose(FBG),fasting insulin(FINS),insulin sensitivity index(ISI)and insulin resistance index(HOMA-IR)were observed,and the association between the HBsAg level and the phospholipid fatty acid spectrum,IR-related indexes was analyze by means of Spearman.RESULTS The levels of serum SFA and n-6/n-3PUFA of the HBV infection-positive group were significantly higher than those of the HBV infection-negative group,the levels of n-6PUFA,n-3PUFA,PUFA and PUFA/SFA of the HBV infection-positive group were significantly lower than those of the HBV infection-negative group(P<0.05).The levels of FBG and HOMA-IR of the HBV infection-positive group were significantly higher than those of the HBV infection-negative group,the levels of FINS and ISI of the HBV infection-positive group were significantly higher than those of the HBV infection-negative group(P<0.05).Spearman correlation analysis showed that the HBsAg level was positively correlated with SFA and n-6/n-3PUFA and was negatively correlated with n-3PUFA,n-6PUFA,PUFA and PUFA/SFA,but it was not correlated with MUFA;the HBsAg level was positively correlated with FBG and HOMA-IR and was negatively correlated with FINS and ISI.CONCLUSION The HBV infection may lead to the change of compositions of serum phospholipid fatty acid and IR in the patients with metabolic syndrome.

关 键 词：乙型肝炎病毒 乙型肝炎病毒表面抗原 磷脂脂肪酸 胰岛素抵抗 

分 类 号：R373[医药卫生—病原生物学]