RESUMO
Cyclic GMP-AMP synthase (cGAS) is a major cytosolic DNA sensor that plays a significant role in innate immunity. Upon binding to double stranded DNA (dsDNA), cGAS utilizes GTP and ATP to synthesize the second messenger cyclic GMP-AMP (cGAMP). The cGAMP then binds to the adapter protein stimulator of interferon genes (STING) in the endoplasmic reticulum, resulting in the activation of the transcription factor interferon regulatory factor 3 (IRF3) and subsequent induction of type I interferon. An important question is how cGAS distinguishes between self and non-self DNA. While cGAS binds to the phosphate backbone of DNA without discrimination, its activation is influenced by physical features such as DNA length, inter-DNA distance, and mechanical flexibility. This suggests that the recognition of DNA by cGAS may depend on these physical features. In this article we summarize the recent progress in research on cGAS-STING pathway involved in antiviral defense, cellular senescence and anti-tumor response, and focus on DNA recognition mechanisms based on the physical features.
RESUMO
Objectives: This study aimed to assess the association between plasma glutamate (Glu) and the risk of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM) and whether this association differs by gender. Material and methods: We retrieved clinical information on 1032 consecutive patients with T2DM from a same tertiary care center from May 2015 to August 2016. Glu was quantified by liquid chromatography-tandem mass spectrometry analysis. Glu was converted into a categorical variable based on the median concentration in the whole population, while logistic regression was used to obtain the odds ratio (OR) and 95% confidence interval (CI), and the correlation between Glu and various biochemical indices was analyzed. Results: We found that Glu was positively associated with the risk of CVD in patients with T2DM. This correlation was more significant in women. In T2DM patients, the higher the age, body mass index (BMI), weight and systolic blood pressure (SBP), the lower the glycosylated hemoglobin (HbA1C) concentration and the higher the Glu. In female patients, the correlation between age, weight, BMI, SBP, and plasma Triglycerides (TG), and Glu was also statistically significant. Conclusion: In conclusion, female T2DM patients with high levels of Glu have a higher risk of developing CVD.
Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Feminino , Humanos , Glicemia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/complicações , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , População do Leste Asiático , Ácido Glutâmico , Fatores de Risco , MasculinoRESUMO
Background: As a highly prevalent malignancy among women worldwide, breast cancer, remains a critical public health issue necessitating the development of novel therapeutics and biomarkers. Kruppel Like Factor 2 (KLF2), a member of the Kruppel family of transcription factors, has been implicated in various types of cancer due to its diminished expression; however, the potential implications of KLF2 expression in relation to breast cancer progression, prognosis, and therapy remain unclear. Methods: The present study employed the Tumor Immune Estimation Resource (TIMER) and The Human Protein Atlas databases to investigate the expression pattern of KLF2 in pan-cancer. The relationship between KLF2 expression and clinical features or immune infiltration of The Cancer Genome Atlas (TCGA) breast cancer samples was evaluated using Breast Cancer Integrative Platform (BCIP) and TIMER. The expression levels of KLF2 in breast cancer were validated via immunohistochemical staining analysis. Gene Set Enrichment Analysis (GSEA) to study the KLF2-related gene ontology. STRING database was employed to construct a protein-protein interaction (PPI) network of KLF2 in relation to vascular endothelial growth factor A (VEGFA) and hypoxia-inducible factor 1α (HIF1α). The expression of KLF2 following diverse breast cancer therapies was analyzed in the Gene Expression Omnibus (GEO) databases. The expression of KLF2 following treatment with simvastatin was validated via immunofluorescence and western blotting. Results: Our study reveals that KLF2 displays significantly reduced expression in cancerous tissues compared to non-cancerous controls. Patients with low KLF2 expression levels exhibited poor prognosis across multiple cancer types. KLF2 expression levels were found to be reduced in advanced cancer stages and grades, while positively correlated with the expression of estrogen receptor (ER), progesterone receptor (PR), and tumor size in breast cancer. KLF2 expression is associated with diverse immune infiltration cells, and may impact the breast tumor immune microenvironment by regulating dendritic cell activation. Additionally, we observed a negative correlation between KLF2 expression levels and angiogenesis, as well as the expression of VEGFA and HIF1α. Notably, the anticancer drug simvastatin could induce KLF2 expression in both breast cancer. Conclusion: Based on our observations, KLF2 has potential as a diagnostic, prognostic, and therapeutic biomarker for breast cancer.
RESUMO
Objective: This study aimed to explore the relationship between homocysteine (Hcy) and diabetic retinopathy (DR) and the impacts of the Hcy pathway on this relationship against this background. Methods: This study retrieved 1979 patients with type 2 diabetes (T2D) from the First Affiliated Hospital of Liaoning Medical University in Jinzhou, Liaoning Province, China. Multiple logistic regression was used to analyze the effects of Hcy cycle on the relationship between Hcy and DR. Spearman's rank correlation analysis was used to analyze the correlation between risk factors related to DR progression and Hcy. Finally, the results of logistic regression were supplemented by mediation analysis. Results: We found there was a negative correlation between low concentration of Hcy and DR (OR : 0.83, 95%CI: 0.69-1). After stratifying all patients by cysteine (Cys) or Methionine (Met), this relationship remained significant only in low concentration of Cys (OR: 0.75, 95%CI: 0.61-0.94). Through the RCS curve, we found that the effect of Hcy on DR presents a U-shaped curve relationship. Mediating effect in Met and Hcy cycles was also significant [Total effect c (OR: 0.968, 95%CI: 0.938-0.998), Direct effect path c' (OR: 0.969, 95%CI: 0.940-0.999), Path a (OR: 1.047, 95%CI: 1.004-1.091), Path b (OR: 0.964, 95%CI: 0.932-0.998)]. Conclusions: The relationship between Hcy and DR presents a U-shaped curve and the homocysteine cycle pathway has an impact on it. And too low concentration of Hcy indicates a lack of other substances, such as vitamins. It is suggested that the progression of DR is the result of a combination of many risk factors. Further prospective studies are needed to determine the role of Hcy in the pathogenesis of DR.
Assuntos
Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Povo Asiático , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/etiologia , Homocisteína , Humanos , Metionina , Fatores de RiscoRESUMO
AIMS: This study aimed to explore relationships short chain fatty acids with diabetic nephropathy (DN) in type 2 diabetes (T2D) patients. METHODS: We extracted the clinical and omics data of 100 T2D patients and 100 DN patients from April 2018 to April 2019 from a tertiary hospital. Restricted cubic splines were used to examine full-range associations of short chain fatty acids with DN in T2D.Query Logistic regression was used to obtain odds ratio (OR) and confidence interval (CI). RESULTS: Acetate, butyrate and isovalerate were negatively correlated with DN. Isobutyrate was positively correlated with DN. Propionate ≥ 4.4 µg/mL and isobutyrate ≥ 1.4 µg/mL had threshold effects and their increasing levels above the cutoff points were associated with rapid rises in the risk of DN. The additive interaction between high propionate and high isobutyrate in serum significantly increased the risk of DN (OR34.35; 95%CI 7.11 to 166.08). Presence of hypertension further increased the OR of high propionate for DN to 8.27(95%CI 1.82 to 37.57) with a significant additive interaction. The additive interaction of the high isobutyrate and hypertension was not significant. CONCLUSIONS: Acetate, butyrate and isovalerate were negatively associated with DN. Isobutyrate was positively associated with DN. Serum high propionate and high isobutyrate worked independently and synergistically to increase the risk of DN in T2D. Presence of hypertension further amplified the effect of copresence of high propionate on DN risk.
Assuntos
Diabetes Mellitus Tipo 2 , Nefropatias Diabéticas , Hipertensão , Butiratos , Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/epidemiologia , Nefropatias Diabéticas/etiologia , Ácidos Graxos Voláteis , Humanos , Hipertensão/complicações , Isobutiratos , PropionatosRESUMO
Objective: Diabetic retinopathy is a common complication of type 2 diabetes mellitus (T2DM). Due to the limited effectiveness of current prevention and treatment methods, new biomarkers are urgently needed for the prevention and diagnosis of DR. This study aimed to explore the relationships between plasma acylcarnitine with DR in T2DM. Methods: From May 2015 to August 2016, data of 1032 T2DM patients were extracted from tertiary hospitals. Potential non-linear associations were tested by binary logistic regression models, and ORs and 95% CIs of the research variables were obtained. Correlation heat map was used to analyze the correlation between variables. The change of predictive ability was judged by the area under the receiver operating characteristic curve. Results: Of the 1032 patients with T2DM, 162 suffered from DR. After adjusting for several confounding variables, C2 (OR:0.55, 95%CI:0.39-0.76), C14DC (OR:0.64, 95%CI:0.49-0.84), C16 (OR:0.64, 95%CI:0.49-0.84), C18:1OH (OR:0.51, 95%CI:0.36-0.71) and C18:1 (OR:0.60, 95%CI:0.44-0.83) were negatively correlated with DR. The area under the curve increased from 0.794 (95% CI 0.745 to 0.842) to 0.840 (95% CI 0.797 to 0.833) when C2, C14DC, C18:1OH and C18:1 added to the traditional risk factor model. Conclusion: There was a negative correlation between C2, C14DC, C16, C18:1OH, and C18:1 and the risk of retinopathy in patients with T2DM. C2, C14DC, C18:1OH, and C18:1 may be new predictors and diagnostic markers of DR.
Assuntos
Diabetes Mellitus Tipo 2 , Retinopatia Diabética , Biomarcadores , Carnitina/análogos & derivados , Diabetes Mellitus Tipo 2/complicações , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/epidemiologia , Retinopatia Diabética/etiologia , Humanos , Curva ROCRESUMO
AIMS/INTRODUCTION: To explore relationships between polyunsaturated fatty acids (PUFA) and non-alcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes, and whether insulin action has an interactive effect with PUFA on NAFLD progression. MATERIALS AND METHODS: We extracted clinical and omics data of 482 type 2 diabetes patients from a tertiary hospital consecutively from April 2018 to April 2019. NAFLD was estimated by ultrasound at admission. Plasma fasting n3 and n6 fatty acids were quantified by liquid chromatography-tandem mass spectrometry analysis. Restricted cubic spline nested in binary logistic regression was used to select the cut-off point, and estimate odds ratios and 95% confidence intervals. Additive interactions of the n6 : n3 ratio with insulin action for NAFLD were estimated using relative excess risk due to interaction, attributable proportion due to interaction and synergy index. Relative excess risk due to interaction >0, attributable proportion due to interaction >0 or synergy index >1 indicates biological interaction. Spearman correlation analysis was used to obtain partial correlation coefficients between PUFA and hallmarks of NAFLD. RESULTS: Of 482 patients, 313 were with and 169 were without NAFLD. N3 ≥800 and n6 PUFA ≥8,100 µmol/L were independently associated with increased NAFLD risk; n6 : n3 ratio ≤10 was associated with NAFLD (odds ratio 1.80, 95% confidence interval 1.20-2.71), and the effect size was amplified by high C-peptide (odds ratio 8.89, 95% confidence interval 4.48-17.7) with significant interaction. The additive interaction of the n6 : n3 ratio and fasting insulin was not significant. CONCLUSION: Decreased n6 : n3 ratio was associated with increased NAFLD risk in type 2 diabetes patients, and the effect was only significant and amplified when there was the co-presence of high C-peptide.
Assuntos
Peptídeo C/sangue , Diabetes Mellitus Tipo 2/sangue , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-6/sangue , Hepatopatia Gordurosa não Alcoólica/sangue , Idoso , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Feminino , Humanos , Pacientes Internados/estatística & dados numéricos , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/etiologia , Razão de ChancesRESUMO
OBJECTIVE: To detect the expression of Toll-like receptor 4 (TLR-4) and NF-κB and to discuss the mechanism of TLR-4/NF-κB pathway in the myocardial ischemia reperfusion injury of mouse. METHODS: TLR-4 mutant mice and wild homozygous mice were divided into the model group and sham group. Mice in the model group were given the ligation of left anterior descending coronary artery for the modeling, while mice in the sham group were not given the ligation after threading. The cardiac muscle tissues were collected for the morphological observation. The immunohistochemistry was employed to detect the expression of NF-κB, Western blot was used to detect the expression of TLR-4 and ELISA to detect the expression of serum inflammatory factors. RESULTS: The expression of NF-κB in TLR-4 null mice after the myocardial ischemia reperfusion was significantly lower than that in wild homozygous mice. For the model group and sham group, the expression of TLR-4 in wild homozygous mice was all significantly higher than that in TLR-4 null mice, while the expression of TLR-4 in TLR-4 null mice in the model group was significantly higher than that in sham group, with the statistical difference (P < 0.05). The expression of inflammatory factors in TLR-4 null mice and wild homozygous mice in the model group was significantly higher than that in sham group. The expression of all factors in group A with TLR-4 null was significantly lower than that in group B with wild homozygous type, with the statistical difference (P < 0.05). CONCLUSIONS: TLR-4/NF-κB pathway is closely related to the myocardial ischemia reperfusion injury, which plays its role through the release of inflammatory cytokines.
RESUMO
OBJECTIVE: The aim of this study was to explore the prevalent characteristics of HBoV1 and its co-infection. METHODS: PCR was used to detect HBoV1-DNA (HBoV1) and other viruses. A multivariate logistic regression model was used to explore possibility of co-detected for related viruses. RESULTS: The positivity rates in Nanjing and Lanzhou were 9.38% (74/789) and 11.62% (161/1386), respectively (P>0.05). The HBoV1 positive group was younger than negative group (P<0.05). Seasonal differences were noted, with a higher frequency of infection in December and July. HBoV1-positive children [72.34% (169/235)] were co-infected with other respiratory viruses. Multifactorial analysis showed no correlations between HBoV1 and the clinical classification, region, gender, age, or treatment as an outpatient or in a hospital. Correlations were identified between HBoV1 infections with ADV (OR=1.53, 95% CI 1.03-2.28), RSV (OR=0.71, 95% CI 0.52-0.98), and IFVA (OR=1.77, 95% CI 1.00-3.13). CONCLUSION: Presence of HBoV1 in nasopharyngeal aspirates did not correlate with region or gender, although the prevalence of HBoV1 was higher in younger children. There were no correlations between HBoV1 and other variables, except for the season and ADV, RSV, or IFVA infections.
Assuntos
Bocavirus Humano/isolamento & purificação , Infecções por Parvoviridae/virologia , Infecções Respiratórias/virologia , Doença Aguda , Pré-Escolar , China/epidemiologia , Comorbidade , DNA Viral/genética , Feminino , Bocavirus Humano/genética , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Infecções por Parvoviridae/epidemiologia , Prevalência , Infecções Respiratórias/epidemiologiaRESUMO
OBJECTIVE: To investigate the prevalence of viral pathogen in children with severe pneumonia in Hunan. METHOD: Bronchoalveolar lavage fluid [BALF] were collected from 122 hospitalized children with severe pneumonia in People's Hospital of Hunan province from January 2011 to December 2011. Nested- or reverse transcription Polymerase chain reaction (PCR or RT-PCR) was used to screen Adenovirus (ADV), Human Bocavirus (HBoV), Parainfluenzaviruses1-4 (PIV1-4), Human Respiratory Syneytial virus (RSV), Influenza virus A (IFVA), Influenza virus B (IFVB), Human Rhinovirus(HRV), Human Metapneumovirus (HMPV), human coronaviruses NL63 and HKU1 (HCoV-NL63, HCoV- HKU1). RESULTS: Among the 122 bronchoalveolar lavage fluid, viral agents were detected in 60 samples(49.1%), among which ADV (40.98%) was the most common virus, followed by RSV (7.37%) and HBoV (7.37%). Two viruses were detected in 21 individual (35%) samples, of which 20 were dual positive for ADV (40%). CONCLUSION: ADV is the most frequently detected viral etiology of severe pneumonia in children in Hunan during this year. And its Coinfection with other respiratory viruses was common.
Assuntos
Líquido da Lavagem Broncoalveolar/virologia , Pneumonia/virologia , Vírus/isolamento & purificação , Adenovírus Humanos/isolamento & purificação , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Estações do AnoRESUMO
UNLABELLED: To investigate the epidemiological features and types of human adenoviruses (ADV) in children with acute respiratory tract infection in Nanjing area, China. Nasopharyngeal aspirates and nasopharyngeal swabs were collected from 644 outpatients or hospitalized pediatric patients with ARTI at the Children Hospital of Nanjing, Jiangsu Province, China, between August 2010 and July 2011. Adenoviruses were identified and typed from the collected clinical specimens by nested-PCR based on the partial region of the hexon gene. Other 12 respiratory viruses including human bocavirus (HBoV), respiratory syncytial virus (RSV), human rhinovirus (HRV), parainfluenza viruses 1-4 (PIV1-4), influenza virus A/B (IFVA/B), human metapneumovirus (HMPV), human coronavirus NL63 and HKU1 (HCoV-HKU1 and HCoV-NL63) were also identified by PCR method. All PCR positive products were sequenced and phylogenetic analysis was conducted. It was showed that adenoviruses were detected in 171 patients out of 644 (26. 55%) children, 120 (70.18%, 120/171) for ADV3, 16 (9.36%,16/171) for ADV7, 12 (7.02%, 12/171) for ADV1, 10 (5.85%, 10/171) for ADV2, 6 (3.51%, 6/171) for ADV5, 3 (1.75%, 3/171) for ADV6, 3 (1.75%, 3/171) for ADV57, and 1 (0.58%,1/171) for ADV41. ADV infection could occur in any season. There was a higher possibility of ADV infection from April to July in 2011. Most cases (96.49%) were younger than 7 years old. A total of 99 of the 171 ADV-positive children (57.89%) were co-infected with other respiratory viruses. Respiratory syncytial virus (RSV) and human rhinovirus (HRV) were the most common additional respiratory viruses, Lower respiratory tract infections were the most frequent diagnoses made in the hospital, in which there were 52 pneumonia (30.4%) cases. CONCLUSION: ADV is one of the most important pathogens of acute respiratory tract infection in children in Nanjing area, and adenovirus type 3 was the most prevalent serotype. It is important to develop long-term surveillance.
Assuntos
Infecções por Adenoviridae/epidemiologia , Adenoviridae/isolamento & purificação , Infecções Respiratórias/epidemiologia , Adenoviridae/classificação , Adenoviridae/genética , Infecções por Adenoviridae/virologia , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Masculino , Dados de Sequência Molecular , Filogenia , Infecções Respiratórias/virologiaRESUMO
OBJECTIVE: To study the infected information, clinical symptom and molecular epidemiological characteristics of HuCV infection among children under 5 years old in Nanjing. METHODS: In Nanjing Children's Hospital of Nanjing Medical University from July 2010 to June 2011, we collected 428 stool specimens from children with diarrhea and 428 asymptomatic controls. Human Calicivirus were tested by using RT-PCR. Then we sequenced the nucleic acid of PCR amplifications and identified the genotype and gene group of prevalent strains. RESULTS: 63 (14.72%) out of 428 stool samples were detected as HuCV. 58 were norovirus and 5 were sapovirus, while GII-4 2006b was the predominant strain of NoV. In the 428 control samples, 19 samples were positive for calicivirus, there were 8 NoV and 13 SaV (Including 3 co-infection cases). CONCLUSION: Human caliciviruses with different genotypes circulated among children in Nanjing,and GII. 2006b is the dominant genotype.
Assuntos
Infecções por Caliciviridae/epidemiologia , Caliciviridae/genética , Diarreia/epidemiologia , Caliciviridae/classificação , Caliciviridae/isolamento & purificação , Infecções por Caliciviridae/virologia , Pré-Escolar , China/epidemiologia , Diarreia/virologia , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Masculino , Epidemiologia Molecular , Filogenia , Estações do AnoRESUMO
OBJECTIVE: To study the clinical and molecular epidemiology characteristics of human Bocavirus 1-3 (HBoV1-3) in children for acute respiratory infection in Lanzhou area. METHODS: Nasopharyngeal aspiration samples and throat swabs were collected from 524 children with ARTI at the First Hospital of Lanzhou University, Gansu Province, China, between December 2009 and November 2010. Nested PCR was employed to screening HBoV1-3, which amplified a 518-bp fragment of the partial NS1 gene. Furthermore, a standard reverse transcription-PCR was used to screen for other common respiratory viruses. RESULTS: The overall frequency of HBoV was 8.2% (43/524), lining up behind human rhinovirus, RSV, parainfluenza virus 3. Thirty of the HBoV-postive children(69.8%) were co-infected with other respiratory viruses. The prevalence of HBoV1 in ALRTI was obviously higher than that in AURI. The 2 HBoV2 NS1 sequences shared 99% and 100% nucleotide sequence identity with HBoV2 strain CU47TH respectively. Two cases of HBoV2 postive children appears gastrointestinal symptoms. The one HBoV3 NS1 sequences shared 99% nucleotide sequence identity with HBoV3 isolate 46-BJ07. CONCLUSION: The HBoV3 was detected at the first time in lanzhou area. HBoV1-3 infection exists in children with acute respiratory tract infections in Lanzhou region, HBoV1 were dominant. The mixed infection rate was higher.
Assuntos
Bocavirus Humano/isolamento & purificação , Infecções Respiratórias/virologia , Doença Aguda , China , Feminino , Bocavirus Humano/classificação , Bocavirus Humano/genética , Humanos , Lactente , Masculino , FilogeniaRESUMO
OBJECTIVE: To investigate the molecular epideiological and clinical feature of human metapneumovirus in children with acute respiratory tract infection in Nanjing city, China. METHOD: Nasopharyngeal aspirates and nasopharyngeal swab were taken from 642 outpatients or hospitalized pediatric patients with acute at the Children Hospital of Nanjing, Jiangsu Province, China, between August 2009 and July 2010. Respiratory speciments were tested for the M gene of hMPV by reverse-transcription polymerase chain reaction (RT-PCR). All RT-PCR positive products were sequenced and phlogenetic analysis was conducted. RESULT: hMPV was detected in 35 (5.5%) of the 642 children. Phylogenetic analysis revealed that 51.4% of the hMPV were B1, 31.4% were A2b. The peak of the positive rate was in April. The majority of the hMPV-positive patients(71.4%) were 0-1 years old. Of the 35 hMPV-positive patients, 15 (42.8%) were co-infected with other respiratory viruses, and human rhinovirus (HRV) were the most common additional respiratory virus. The most common clinical diagnosis was pneumonia (48.6%). CONCLUSION: Human metapneumovirus is an important pathogen of acute respiratory tract infection in children in Nanjing city. The subtype B1 was the predominating lineage in 2009-2010 in Nanjing city. No significant differences were found for clinical characteristics between genotype A and genotype B human metapneumovirus infection in children in Nanjing.
Assuntos
Metapneumovirus/isolamento & purificação , Infecções Respiratórias/virologia , Doença Aguda , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Masculino , Metapneumovirus/classificação , Metapneumovirus/genética , Filogenia , Infecções Respiratórias/epidemiologia , Reação em Cadeia da Polimerase Via Transcriptase ReversaRESUMO
BACKGROUND AND AIMS: The clinical significance of hepatic steatosis in chronic hepatitis B infection (CHB) is unclear. The aims of this study were thus to investigate the prevalence and risk factors for hepatic steatosis in patients with CHB and its relationship with liver injury. METHODS: Consecutive patients with biopsy-proven CHB at Hangzhou Sixth People's Hospital between January 2005 and June 2007 were included. Patients co-infected with other viruses or suffering from liver disease of any other cause were excluded. Liver steatosis, necroinflammation and fibrosis were assessed by both Brunt and Scheuer classifications. RESULTS: A total of 1915 patients (1497 men) with a mean age of 31 +/- 9.5 years were analyzed. Hepatic steatosis was present in 260 (14%) patients. The steatosis involved < 33% of hepatocytes in 90% of cases, and was more frequent among men than women (15% vs 8%, P < 0.001). Two-thirds (178 of 260) of patients with steatosis were hepatitis B e antigen (HBeAg)-positive, but there was no correlation with either serum HBeAg status or hepatitis B virus DNA titer. Degree of inflammation and fibrosis were more mild among those with steatosis than those without. Multivariate analysis showed that steatosis was independently associated with body mass index, serum triglyceride, apolipoprotein B, uric acid, and fasting blood glucose. However, fibrosis was only independently associated with age and inflammatory grade, and the latter associated with viral load and fibrosis stage. CONCLUSIONS: Hepatic steatosis is common in CHB, it is associated with metabolic factors not viral ones, and does not appear to affect the severity of liver disease.
Assuntos
Povo Asiático , Fígado Gorduroso/etiologia , Hepatite B Crônica/complicações , Cirrose Hepática/virologia , Fígado/patologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Povo Asiático/estatística & dados numéricos , Criança , China/epidemiologia , Fígado Gorduroso/etnologia , Fígado Gorduroso/metabolismo , Fígado Gorduroso/patologia , Fígado Gorduroso/virologia , Feminino , Hepatite B Crônica/etnologia , Hepatite B Crônica/metabolismo , Hepatite B Crônica/patologia , Humanos , Fígado/virologia , Cirrose Hepática/etnologia , Cirrose Hepática/patologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Adulto JovemRESUMO
OBJECTIVES: To investigate the prevalence and risk factors of hepatic steatosis in patients with biopsy-proven chronic hepatitis B (CHB). METHODS: One thousand nine hundred and fifteen patients with CHB who had liver biopsies seen between January 2005 and June 2007 in our department were reviewed. Patients co-infected with hepatitis C virus or HIV or suffering from liver diseases of other causes were not included. The prevalence of hepatic steatosis and its trend during the study period were determined, and the relationships among their hepatic steatosis with clinical data, serum biochemistry, HBV viral load, and the degree of liver inflammation and fibrosis stage were studied. RESULTS: The mean age of the patients was 30.7+/-9.5 years; 1,497 men and 418 women. Histological hepatic steatosis was present in 260 patients (13.6%), and the annual prevalence of steatosis increased with time (11.2% in 2005, 14.3% in 2006, and 17.9% in 2007). The prevalence of steatosis in male patients was significantly higher than that in female patients (15.2% vs. 7.7%, chi2 = 15.98, P less than 0.01). Body mass index (BMI), age, fasting plasma glucose (FPG) were all significantly higher in CHB patients with hepatic steatosis than in patients without steatosis (t values were 6.01, 3.60, 4.72 and 9.55, respectively, all P less than 0.01). The prevalence of overweight, obesity, diabetes, dyslipidemia and hyperuricemia were also significantly higher in patients with steatosis than those without it (chi2 values 17.00, 169.45, 6.12, 116.67 and 76.34, all P less than 0.05). Prevalence of hepatic steatosis was higher in patients with mild CHB (17.8%) than in chronic inactive HBsAg carriers (8.6%), patients with moderate CHB (9.4%) and with severe CHB (7.7%). Similarly, prevalence of steatosis was higher in patients with inflammation grade 1 (19.8%) and fibrosis stage 1 (19.1%) than in patients with inflammation grade 0 (10.3%), grade 2 (11.5%), grade 3 (9.3%) and grade 4 (7.3%), and in patients with fibrosis stage 0 (10.8%), stage 2 (13.3%), stage 3 (7.1%) and stage 4 (7.4%), respectively. No close relationship was found between hepatic steatosis and serum HBeAg status or HBV DNA titer in patients with CHB. Logistic regression analysis demonstrated that the presence of steatosis was positively correlated to BMI, serum triglyceride, apolipoprotein B, uric acid and FPG. CONCLUSION: Hepatic steatosis is not uncommon in patients with CHB. It is associated with metabolic factors of the hosts and not related to the virus itself. It is also not related to the degrees of liver inflammation and fibrosis.
Assuntos
Fígado Gorduroso/epidemiologia , Hepatite B Crônica/metabolismo , Fígado/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Fígado Gorduroso/metabolismo , Fígado Gorduroso/patologia , Feminino , Hepatite B Crônica/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Adulto JovemRESUMO
OBJECTIVE: To explore the viral and host causes of hepatosteatosis in Chinese patient with chronic hepatitis B. METHODS: A total of 562 patients (450 males and 112 females, age range 13-80 years) with biopsy-proven chronic hepatitis B were enrolled in the study. The patients were divided into two groups: group without steatosis (460 patients) and group with steatosis (102 patients). The groups were compared in terms of age, gender, body mass index (BMI), liver enzymes, cholesterol, triglyceride, APO-A, APO-B, urine acid (UA), fasting serum glucose (FSG) and HBeAg, viral load. RESULTS: Steatosis was present in 102 patients (18.15%). The degree of liver steatosis in 97 (95.10%) patients were less 30%. Steatosis was found in 98 (21.78%) of male patients and 4 (3.75%) of female patients (P < 0.01). In the group of chronic hepatitis B with steatosis, the prevalence of obesity, diabetes mellitus, dyslipidaemia, alcoholic consumption, the BMI, cholesterol, triglyceride, UA and FSG levels were significantly higher than those in the group without steatosis (P < 0.01). No significant difference was found in the mean age, HBeAg, viral load between the two groups (P > 0.05). Logistic regression analysis demonstrated that the present of steatosis was positively correlated to BMI, TG and UA. CONCLUSION: Hepatosteatosis in chronic hepatitis B appears to be a result of metabolic factors of the host rather than the effect of viruses.