scholarly journals Assessment of Hepatic Steatosis in Patients with Chronic Hepatitis B Using Fibroscan and its Relation to Insulin Resistance

2019 ◽  
Vol 9 (1) ◽  
pp. 70-78
Author(s):  
Reham M. Gameaa ◽  
Nehad Hawash ◽  
Rehab Badawi ◽  
Sherief Abd-Elsalam ◽  
Gamal K. Kasem ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Hepatic Steatosis ◽  
Chronic Hepatitis B ◽  
P Value ◽  
Fasting Insulin ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background & Aim: Simple hepatic steatosis is a benign condition, but it may cause serious liver damage as it may lead to steatohepatitis, fibrosis and cirrhosis. The Controlled Attenuation Parameter (CAP) of fibroscan assesses hepatic steatosis. The aim of this work was to assess hepatic steatosis in patients with chronic hepatitis B infection using FibroScan and to detect its relation to insulin resistance. Methods: Seventy-seven patients with chronic HBV were enrolled in this study. Body mass index, complete lipid profile, fasting insulin, HOMA-IR, pelviabdominal ultrasound and fibroscan were assessed in all patients. Results: According to the presence of significant steatosis, seventy-seven patients enrolled in this study were divided into different groups, such as group I 47 patients (61.04%) with CHB virus infection with non-significant steatosis and group II 30 patients (38.96%) with CHB infection with significant steatosis. There was a statistically significant increase in fasting insulin and HOMA-IR in group II (p-value <0.001). CAP results ranged from 100-396 db/m with no significant difference in liver stiffness measurements in two studied groups (P value= 0.886). There was a significant positive correlation between the degree of hepatic steatosis measured by fibroscan and fasting insulin blood level, HOMA-IR, serum cholesterol and LDL. At cutoff > 222 db/m steatosis measured by fibroscan had a sensitivity of 63.33% and specificity of 82.35% for the detection of insulin resistance. Conclusion: In CHB infected patients, steatosis measurement by fibroscan was a strong predictor of Insulin Resistance (IR) and vice versa.

Impact of Direct Acting Antivirals therapy on metabolic profiles and adiponectin serum level in Egyptian patients with chronic hepatitis C infection

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Lotfy Fahmy Abd Elmeged ◽  
Sameh Mohamed Fahim Ghaly ◽  
Osama Ashraf Ahmed ◽  
Ahmed Samir Abohalima ◽  
Ahmed Samir Allam ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Lipid Profile ◽  
Chronic Hepatitis C ◽  
Adiponectin Level ◽  
Fasting Insulin ◽  
Group I ◽  
Significant Difference ◽  
Before And After ◽  
Group Ii

Abstract Background and Objectives Hepatitis C Virus (HCV) infection is a major global health challenge. Chronic hepatitis C viral infection is associated with wide metabolic disarrangements. HCV interacts with lipid metabolism leading to steatosis, causing wide adipocytokines changes and impairs glucose metabolism leading to increased prevalence of insulin resistance (IR) and type 2 diabetes. Several oral anti-HCV drugs (direct acting antivirals; DAAs) have been developed over the last several years. Now, HCV can be eliminated from the infected host within 12 weeks of DAA combination therapy. As, there is limited data on the effects of DAA therapy on metabolic profiles, lipid profile and adiponectin level. Hence, this study was carried out to evaluate the Impact of Direct Acting Antivirals therapy on metabolic profiles and adiponectin serum level in Egyptian patients with chronic hepatitis C infection. Methods This study was performed on 100 patients who have chronic infection with hepatitis C, patients were divided into two groups, Group I was 50 patients were treated with (Sofosbuvir/Daclatasvir/Ribavirin) for 3 months. Group II was 50 patients were treated with (Ombitasvir, Paritaprevir, Ritonavir/Ribavirin) for 3 months. With follow up changes were occurred in Fasting Lipid profile (total cholesterol, triglyceride, HDL and LDL), metabolic profile (fasting blood sugar, Fasting Insulin, HOMA-IR and HBA1C) and Serum adiponectin level before and after end of treatment. Results One hundred patients met inclusion criteria were reviewed, (56%) were males in group I while (46%) were males in group I, Mean age in group I was 47.4 ± 5.3 years while in group II was 43.2 ± 6.6 years, statistical analysis of data showed significant difference in the lipid profile in group I before and after treatment .As, we found significant reduction in serum triglycerides after treatment (113.2 ± 22.9 mg/dL vs 105.6 ± 23.2 mg/dL, P &lt; 0.001) and a significant elevation of serum Total Cholesterol, LDL and HDL after treatment (TC: 153.2 ± 20.1 mg/dL vs 174.1 ± 19 mg/dL, P &lt; 0.001, LDL: 74.7 ± 9.9 mg/dL vs 93.3 ± 12 mg/dL, P &lt; 0.001, HDL: 54.6 ± 10.1 mg/dL vs 57.2 ± 10.3 mg/dL, P 0.010) But in group II there was no significant difference in the lipid profile before and after treatment, Also, We found significant reduction in fasting insulin, HOMAIR and HBA1C after treatment in group I (Fasting Insulin: 11.4 ± 3.3 (uU/L)/ml vs 9.7 ± 2.2 (uU/L)/ml, P &lt; 0.001, HOMA-IR: 2.7 ± 0.9 vs 2.2 ± 0.6, P &lt; 0.001, HBA1C: 5.6 ± 0.4 vs 5.4 ± 0.3, P 0.003) But in group II there was no significant difference in fasting insulin, HOMA-IR and HBA1C before and after treatment. Also, we found that there was no significant changes in the serum adiponectin level in the both group before and after treatment. Conclusion Eradication of chronic hepatitis C viral infection with DAAs may affect the lipid and the metabolic profile of patients after the end of treatment according to the type of DAAs used in the treatment and according to the stage of the liver disease of patients. But not affect the serum Adiponectin level.

scholarly journals Coexistence of Hepatitis B Surface Antigen (HBs Ag) and Anti-HBs Antibodies in Chronic Hepatitis B Virus Carriers: Influence of “a” Determinant Variants

2006 ◽  
Vol 80 (6) ◽  
pp. 2968-2975 ◽  
Author(s):  
Olivier Lada ◽  
Yves Benhamou ◽  
Thierry Poynard ◽  
Vincent Thibault
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Surface Antigen ◽  
Immune Escape ◽  
Hepatitis B Surface Antigen ◽  
Group I ◽  
Group Ii ◽  
Hbs Ag ◽  
Selection Of

ABSTRACT In chronic hepatitis B (CHB), the persistence of hepatitis B surface antigen (HBs Ag) is sometimes associated with antibodies (Ab) to HBs (anti-HBs). To assess the hypothesis of the selection of HBs Ag immune escape variants in CHB patients, the variability of the HBV S gene was determined for patients persistently carrying both HBs Ag and anti-HBs antibodies and patients solely positive for HBs Ag. We selected 14 patients who presented both markers (group I) in several consecutive samples and 12 patients positive for HBs Ag only (group II). The HBs Ag-encoding gene was amplified and cloned, and at least 15 clones per patient were sequenced and analyzed. The number of residue changes within the S protein was 2.7 times more frequent for group I than for group II patients and occurred mostly in the “a” determinant of the major hydrophilic region (MHR), with 9.52 versus 2.43 changes per 100 residues (P = 0.009), respectively. Ten patients (71%) from group I, but only three (25%) from group II, presented at least two residue changes in the MHR. The most frequent changes in group I patients were located at positions s145, s129, s126, s144, and s123, as described for immune escape variants. In CHB patients, the coexistence of HBs Ag and anti-HBs Ab is associated with an increase of “a” determinant variability, suggesting a selection of HBV immune escape mutants during chronic carriage. The consequences of this selection process with regard to vaccine efficacy, diagnosis, and clinical evolution remain partially unknown.

scholarly journals Chronic hepatitis B associated with hepatic steatosis, insulin resistance, necroinflammation and fibrosis

2015 ◽  
Vol 15 (3) ◽  
pp. 714 ◽  
Author(s):  
B Yilmaz ◽  
S Koklu ◽  
H Buyukbayram ◽  
K Yalçin ◽  
U Korkmaz ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Hepatic Steatosis ◽  
Chronic Hepatitis B

scholarly journals PLATELET INDICES FOR PREDICTING LIVER FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS B INFECTION

2019 ◽  
Vol 25 (1) ◽  
pp. 35
Author(s):  
Shendy Sherly Soeliauwan ◽  
Darwati Muhadi ◽  
Mutmainnah Mutmainnah
Keyword(s):  
Chronic Hepatitis ◽  
Platelet Count ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
P Value ◽  
Severe Liver ◽  
Distribution Width ◽  
Platelet Size ◽  
Significant Difference

Chronic Hepatitis B involves liver parenchymal destruction leading to fibrosis. Decreased serum thrombopoietin associated with liver cell failure is thought as the leading cause of thrombocytopenia. Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) describe platelet size and degree of variation in platelet size respectively. The researchers intended to investigate whether platelet count, MPV, and PDW were variables to determine the severity of liver fibrosis in chronic hepatitis B patients. An observational study was carried out at the Dr. Wahidin Sudirohusodo Hospital Makassar from January 2015 until December 2016. A total of 100 chronic hepatitis B patients with negative HBeAg who underwent Fibroscan and complete blood count test were included in this study. A total of 100 chronic hepatitis B patients comprising, 11 with severe liver fibrosis, 16 with moderate liver fibrosis, 46 with mild liver fibrosis, and 27 with normal liver. There were significant differences in platelet count and MPV among liver fibrosis groups with p-value <0.001 and 0.046 respectively. No significant difference was observed for PDW among liver fibrosis groups (p=0.131). This study showed that platelet count and MPV were significantly different among the normal group, mild liver fibrosis group, moderate liver fibrosis group and severe liver fibrosis group in chronic hepatitis B patients. The researchers recommend to carry out studies with larger samples in number and distributed more evenly.

scholarly journals PNPLA3rs1010023 Predisposes Chronic Hepatitis B to Hepatic Steatosis but Improves Insulin Resistance and Glucose Metabolism

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Qin Pan ◽  
Mei-Mei Chen ◽  
Rui-Nan Zhang ◽  
Yu-Qin Wang ◽  
Rui-Dan Zheng ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Chronic Hepatitis ◽  
Glucose Metabolism ◽  
Hepatitis B ◽  
Hepatic Steatosis ◽  
Chronic Hepatitis B ◽  
Normal Population ◽  
Fasting Blood Glucose ◽  
Model Assessment ◽  
Assessment Index

PNPLA3polymorphisms serve as the genetic basis of hepatic steatosis in normal population and lead to dysregulated glucose metabolism. Whether it underlies the hepatic steatosis and glucose homeostasis in chronic hepatitis B patients remains uncertain. Here, we investigated thePNPLA3polymorphisms in biopsy-proven chronic hepatitis B patients with (CHB+HS group,n=52) or without hepatic steatosis (CHB group,n=47) and non-CHB subjects with (HS group,n=37) or without hepatic steatosis (normal group,n=45). When compared to the TT genotype, C-allele atPNPLA3rs1010023 (CC and TC genotypes) conferred higher risk to hepatic steatosis in chronic hepatitis B patients (odds ratio (OR) = 1.768, 95% confidence interval (CI): 1.027–3.105;P=0.045) independent of age, gender, and body mass index. In contrast to their role in hepatic steatosis, CC and TC genotypes ofPNPLA3rs1010023 were correlated to significant improvement of homeostasis model assessment index (HOMA-IR) as compared to TT genotype in the CHB+HS group. Downregulated fasting blood glucose also characterized the CHB+HS patients with C-allele atPNPLA3rs1010023 (CC/TC versus TT: 4.81 ± 0.92 mmol/L versus 5.86 ± 2.11 mmol/L,P=0.02). These findings suggest thatPNPLA3rs1010023 may predispose chronic hepatitis B patients to hepatic steatosis but protects them from glucose dysregulation by attenuating insulin resistance.

scholarly journals ANALYSIS OF PLATELET COUNT ON FIBROSIS DEGREE IN CHRONIC HEPATITIS B PATIENTS

2018 ◽  
Vol 24 (2) ◽  
pp. 165
Author(s):  
Hairul Anwar ◽  
Mutmainnah Mutmainnah ◽  
Ibrahim Abdul Samad
Keyword(s):  
Chronic Hepatitis ◽  
Platelet Count ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Complete Blood Count ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
B Virus ◽  
Spearman Correlation Test

Chronic hepatitis B is an infectious liver disease caused by hepatitis B virus that persist for more than 6 months. Fibrosis is a result of fibrogenesis which is the formation of connective tissue (scarring) caused by liver tissue damage. Liver damage will affect the production of thrombopoetin causing disturbances in the balance between destruction and production of platelet resulting in decreased platelet counts. This study was a retrospective cross-sectional study by taking the data from medical records of chronic hepatitis B patients who were tested for complete blood count and fibroScan at the Dr.Wahidin Sudirohusodo Hospital Makassar from January 2014 to July 2016. The result showed a total of 323 chronic B hepatitis patients, 99 with severe fibrosis, 84 with moderate fibrosis and 140 with mild fibrosis. The Spearman correlation test showed a significant correlation between the platelet count and the degree of fibrosis (p <0.001) and showed a positive correlation between both of them with a very strong correlation (r = 0.802). The Kruskal-Wallis test showed a significant difference between platelet count and the degree of fibrosis (p<0.001). The conclusion is that a decreased platelet count is a sign of an increase in the degree of fibrosis in chronic hepatitis B patients. It is suggested to perform another study with larger samples based on the degree of fibrosis. 

scholarly journals Results of modern tuboperitoneal infertility treatment

2009 ◽  
Vol 66 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Drenka Turjacanin-Pantelic ◽  
Dragana Bojovic-Jovic ◽  
Biljana Arsic ◽  
Eliana Garalejic
Keyword(s):  
Statistical Analysis ◽  
Surgical Treatment ◽  
Infertility Treatment ◽  
P Value ◽  
Modern Approach ◽  
Vitro Fertilization ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background/Aim. A modern approach to surgical treatment of tuboperitoneal infertility is based on laporascopic techniques. The aim of this study was to compare results of tuboperitoneal infertility treatment by the use of laparoscopy and classical laparotomy. Methods. A retrospectiveprospective study on 66 women treated operatively form tuboperitoneal infertility was performed. Data from patient's anamnesis and those related to the surgical treatment results, obtained by the use of an inquiry, were used in retrospective and prospective analysis, respectively. Chi-square test was used in statistical analysis. P value < 0.05 was considered significant. Results. Classical laparotomy was used on 34 women in a period from 1996 to 1997, while 32 women were operated laparoscopically in a period from 1999 to 2000. The results were as follows: a total number of conceived women was 16 (24%), seven in the group I (20.6%) and nine in the group II (28.1%); 13 women were with one pregnancy, six in the group I (17.6%) and seven in the group II (22%). Twice pregnant were three women, one in the group I (2.9%) and two in the group II (6.2%). The resulting pregnancies were: five women with abortion spontaneous, two in the group I (5.9%) and three in the group II (9.4%); two women with extrauterine pregnancy in the group I (5.9%); three with pretemporal birth, one in the group I (2.9%) and two in the group II (6.2%), while six women were with the temporal birth, two in the group I (5.9%) and four in the group II (12.5%). Statistical analysis showed that there was no significant difference in the results between these two groups. Conclusion. Surgical treatment of tubeperitoneal infertility, regardless of the used methods (classical laparotomy or laparoscopy) was successful in a great number of women. These methods have a great advantage over in vitro fertilization, and they should not be ignored.

Sign in / Sign up

Export Citation Format

Share Document