AP&T：慢丙肝与代谢性疾病及心脏病相关

　　近日，2013年第37卷第6期《消化药理学和治疗学》杂志研究评估了美国人群慢性丙肝与心血管疾病危险因素的关系，称慢性丙型肝炎感染与代谢性疾病（胰岛素抵抗、糖尿病）、高血压和充血性心力衰竭独立相关。

　　该研究调查了1999年至2010年之间国家健康和营养研究调查（NHANES）的数据。

　　该研究将19741名受试者纳入研究，173例（0.88%）中可检出HCV RNA并认为他们有慢性丙型肝炎。研究显示，与对照组相比，慢性丙肝病人主要是非洲裔美国人（23.5%和10.5%，P<0.0001），男性（66.6%和46.1%，P=0.0001），更多出现在45之55岁年龄段（41.9%和20.4%，P=0.0001），胰岛素抵抗（44.1%和31.1%，P=0.0301）和高血压（40.1%和28.9%，P=0.0201）的风险更高，吸烟的人数更多（76.2%和29.9%，P<0.0001）。多因素分析中，除了胰岛素抵抗已知的危险因素外，慢性丙肝与胰岛素抵抗（OR=2.06，95% CI 1.19-3.57）、糖尿病（OR=2.31，95% CI 1.18-4.54）和高血压（OR=2.06，95% CI 1.30-3.24）独立相关。心血管疾病的独立预测因素包括高龄、肥胖和吸烟。慢性丙肝与心血管疾病中的充血性心力衰竭独立相关而与缺血性心脏病和卒中并无显著关联。

与丙肝相关的拓展阅读：

• Liver Transpl：美国老年丙肝患者肝移植需求增多
• NEJM：Sofosbuvir用于慢性丙肝病毒感染初治安全有效
• Clin Infect Dis：血清标志物FIB-4或可用于慢性丙肝纤维化分期
• Hepatology：VitA缺乏——丙肝抗病毒治疗失败的“疑凶”
• Hepatology：丙肝肝硬化大多因酗酒导致 更多信息请点击：有关丙肝更多资讯

Associations of chronic hepatitis C with metabolic and cardiac outcomes.
BACKGROUND
Chronic hepatitis C virus (CH-C) infection is associated with metabolic conditions such as insulin resistance and type 2 diabetes (DM) and may increase the risk of cardiovascular diseases.
AIM
To assess the association of CH-C with risk factors for cardiovascular diseases using US population data.
METHODS
The National Health and Nutrition Examination Surveys (NHANES) collected between 1999 and 2010 were used.
RESULTS
Of 19 741 participants considered eligible for the study. Of this cohort, 173 individuals (0.88%) had detectable HCV RNA and were considered to have CH-C. Compared with controls, CH-C patients were predominantly African American (23.5% vs. 10.5%, P < 0.0001), men (66.6% vs. 46.1%, P = 0.0001), more likely to be between 45 and 55 years of age (41.9% vs. 20.4%, P = 0.0001), had higher rate of insulin resistance (44.1% vs. 31.1%, P = 0.0301), hypertension (40.1% vs. 28.9%, P = 0.0201), and history of smoking (76.2% vs. 29.9%, P < 0.0001). In multivariate analysis, in addition to known risk factors for insulin resistance, CH-C was independently associated with the presence of insulin resistance [OR (95% CI) = 2.06 (1.19-3.57)], DM [OR = 2.31 (1.18-4.54)] and hypertension [OR = 2.06 (1.30-3.24)]. Independent predictors of cardiovascular diseases included older age, presence of obesity and smoking. CH-C was independently associated with congestive heart failure subtype of cardiovascular diseases but not ischaemic heart disease and stroke.
CONCLUSION
Chronic hepatitis C virus infection is independently associated with presence of metabolic conditions (insulin resistance, type 2 diabetes mellitus and hypertension) and congestive heart failure.