Lipid Profiles and Hepatitis C Viral Markers in HCV-Infected Thalassemic Patients
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: The distribution of blood lipids, glucose and their determinants in thalassemic patients with chronic hepatitis C virus (HCV) infection has rarely been investigated. Thus, we aimed to investigate the relationship between both liver histologic findings and viral markers and serum lipids in thalassemic patients chronically infected with HCV. Methods: We enrolled 280 polytransfused thalassemic patients with chronic hepatitis C. HCV viral load was determined using the Amplicor test. Genotyping was performed using genotype specific primers. Fasting serum lipid, glucose, ferritin and liver function enzyme concentrations were measured. A modified Knodell scoring system was used to stage liver fibrosis and to grade necroinflammatory activity. Perls’ staining was used to assess hepatic siderosis. Results: Just one subject had total cholesterol >200 mg/dL, and 7% had triglycerides >150 mg/dL. The mean high-density lipoprotein cholesterol (HDL-C) and glucose levels were 37 and 104 (97-111) mg/dL, respectively. Viral markers, liver histological findings and aminotransferase activity were not associated with serum lipid levels. Serum triglycerides, total cholesterol and ferritin were independent risk factors for impaired glucose tolerance or diabetes in these patients. Conclusions: The majority of the patients had blood lipid levels (with the exception of HDL) within the defined normal range; viral and liver histological factors do not appear to play a significant role in changing the levels of serum lipids or glucose in these patients.
Abstract
Background/Aims: The distribution of blood lipids, glucose and their determinants in thalassemic patients with chronic hepatitis C virus (HCV) infection has rarely been investigated. Thus, we aimed to investigate the relationship between both liver histologic findings and viral markers and serum lipids in thalassemic patients chronically infected with HCV. Methods: We enrolled 280 polytransfused thalassemic patients with chronic hepatitis C. HCV viral load was determined using the Amplicor test. Genotyping was performed using genotype specific primers. Fasting serum lipid, glucose, ferritin and liver function enzyme concentrations were measured. A modified Knodell scoring system was used to stage liver fibrosis and to grade necroinflammatory activity. Perls’ staining was used to assess hepatic siderosis. Results: Just one subject had total cholesterol >200 mg/dL, and 7% had triglycerides >150 mg/dL. The mean high-density lipoprotein cholesterol (HDL-C) and glucose levels were 37 and 104 (97-111) mg/dL, respectively. Viral markers, liver histological findings and aminotransferase activity were not associated with serum lipid levels. Serum triglycerides, total cholesterol and ferritin were independent risk factors for impaired glucose tolerance or diabetes in these patients. Conclusions: The majority of the patients had blood lipid levels (with the exception of HDL) within the defined normal range; viral and liver histological factors do not appear to play a significant role in changing the levels of serum lipids or glucose in these patients.
참고문헌 (35)
- Alavian SM, "Hepatitis C infection in the general population of Iran: a systematic review", Hepat Mon, 9, pp.211~223 (2009)
- Alavian SM, "Epidemiology of HCV infection among thalassemia patients in eastern Mediterranean countries: a quantitative review of literature", Iran Red Crescent Med J, 12, pp.365~376 (2010)
- Siagris D, "Serum lipid profile and hepatic steatosis of adult beta-thalassaemia patients with chronic HCV infection", Eur J Gastroenterol Hepatol, 17, pp.345~350 (2005)
- Cicognani C, "Serum lipid and lipoprotein patterns in patients with liver cirrhosis and chronic active hepatitis", Arch Intern Med, 157, pp.792~796 (1997)
- Maggi G, "Serum cholesterol and chronic hepatitis C", Ital J Gastroenterol, 28, pp.436~440 (1996)
- Biró A, "Serum anti-cholesterol antibodies in chronic hepatitis-C patients during IFN-alpha-2b treatment", Immunobiology, 207, pp.161~168 (2003)
- Minuk GY, "Serum cholesterol and low-density lipoprotein cholesterol levels as predictors of response to interferon therapy for chronic hepatitis C", Ann Intern Med, 132, pp.761~762 (2000)
- Fabris C, "Blood lipids of patients with chronic hepatitis: differences related to viral etiology", Clin Chim Acta, 261, pp.159~165 (1997)
- Agnello V, "Hepatitis C virus and other flaviviridae viruses enter cells via low density lipoprotein receptor", Proc Natl Acad Sci U S A, 96, pp.12766~12771 (1999)
- Cheng J, "Low density lipoprotein receptor: a receptor related to hepatitis C virus", Zhonghua Gan Zang Bing Za Zhi, 11, pp.190~192 (2003)
- Wünschmann S, "Characterization of hepatitis C virus (HCV) and HCV E2 interactions with CD81 and the low-density lipoprotein receptor", J Virol, 74, pp.10055~10062 (2000)
- Chrysohoou C, "Distribution of serum lipids and lipoproteins in patients with beta thalassaemia major: an epidemiological study in young adults from Greece", Lipids Health Dis, 3, pp.3~ (2004)
- Al-Quobaili FA, "Serum levels of lipids and lipoproteins in Syrian patients with beta-thalassemia major", Saudi Med J, 25, pp.871~875 (2004)
- Rahimi Z, "Plasma lipids in Iranians with sickle cell disease: hypocholesterolemia in sickle cell anemia and increase of HDL-cholesterol in sickle cell trait", Clin Chim Acta, 365, pp.217~220 (2006)
- Friedewald WT, "Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge", Clin Chem, 18, pp.499~502 (1972)
- Yamaki K, "Prevalence of obesity-related chronic health conditions in overweight adolescents with disabilities", Res Dev Disabil, 32, pp.280~288 (2011)
- Keshvari M, "Distribution of hepatitis C virus genotypes in iranian patients with congenital bleeding disorders", Iran Red Crescent Med J, 12, pp.608~614 (2010)
- Azizi F, "Serum lipid levels in an Iranian population of children and adolescents: Tehran Lipid and Glucose Study", Eur J Epidemiol, 17, pp.281~288 (2001)
- Madani H, "lipids and lipoproteins in children and young adults with major beta-thalassemia from western Iran: influence of genotype", Mol Biol Rep, 38, pp.2573~2578 (2011)
- Fesharakinia A, "Lipid profiles and prevalence of dyslipidemia in schoolchildren in south Khorasan Province, eastern Iran", Arch Iran Med, 11, pp.598~601 (2008)
- Sharifi F, "Dinmohammadi M. High prevalence of low high-density lipoprotein cholesterol concentrations and other dyslipidemic phenotypes in an Iranian population", Metab Syndr Relat Disord, 6, pp.187~195 (2008)
- Papanastasiou DA, "Beta-Thalassaemia and factors affecting the metabolism of lipids and lipoproteins", Haematologia (Budap), 27, pp.143~153 (1996)
- Hartman C, "Hypocholesterolemia in children and adolescents with beta-thalassemia intermedia", J Pediatr, 141, pp.543~547 (2002)
- Yokoyama M, "Low serum lipids suggest severe bone marrow failure in children with aplastic anemia", Pediatr Int, 42, pp.613~619 (2000)
- Shalev H, "Hypocholesterolemia in chronic anemias with increased erythropoietic activity", Am J Hematol, 82, pp.199~202 (2007)
- Ghoddusi K, "Association of diabetes mellitus and dyslipidaemias in the Tehran population", East Mediterr Health J, 14, pp.647~653 (2008)
- Hadaegh F, "High prevalence of undiagnosed diabetes and abnormal glucose tolerance in the Iranian urban population: Tehran Lipid and Glucose Study", BMC Public Health, 8, pp.176~ (2008)
- Dmochowski K, "Factors determining glucose tolerance in patients with thalassemia major", J Clin Endocrinol Metab, 77, pp.478~483 (1993)
- Prati D, "Viral and metabolic factors influencing alanine aminotransferase activity in patients with chronic hepatitis C", J Hepatol, 44, pp.679~685 (2006)
- Hsu CS, "Association of lipid profiles with hepatitis C viral load in chronic hepatitis C patients with genotype 1 or 2 infection", Am J Gastroenterol, 104, pp.598~604 (2009)
- Petit JM, "Hepatitis C virus-associated hypobetalipoproteinemia is correlated with plasma viral load, steatosis, and liver fibrosis", Am J Gastroenterol, 98, pp.1150~1154 (2003)
- Maeno T, "Mechanisms of increased insulin resistance in non-cirrhotic patients with chronic hepatitis C virus infection", J Gastroenterol Hepatol, 18, pp.1358~1363 (2003)
- Wrede CE, "Association between serum ferritin and the insulin resistance syndrome in a representative population", Eur J Endocrinol, 154, pp.333~340 (2006)
- Sougleri M, "Chronic hepatitis C virus infection without cirrhosis induces insulin resistance in patients with alpha-thalassaemia major", Eur J Gastroenterol Hepatol, 13, pp.1195~1199 (2001)
- D’Souza RF, "Relationship between serum ferritin, hepatic iron staining, diabetes mellitus and fibrosis progression in patients with chronic hepatitis C", Aliment Pharmacol Ther, 21, pp.519~524 (2005)