Effect Of Chronic Hepatitis B Virus On Insulin Resistance And Its Mechanism

Objective To investigate the factors associated with insulin resistance(IR) in patients with chronic hepatitis B virus (HBV) infection and itsmechanism.Methods1.sixty eight patients with mild chronic hepatitis B(MCHB)caused by HBV served as case, sixty seven subjects with non-hepatitis virusinfection and normal liver function served as normal control(NC) wereenrolled in the study. Demographic, anthropometric, clinical, and bloodbiochemical parameters were compared between groups.The potentialfactors associated with IR were evaluated.2. Thirty six hepatic tissues werecollected, which were obtained from MCHB with IR (level of HOMA-IRwas greater than2.7, n=12), MCHB without IR (level of HOMA-IR was lessthan2.7,n=12) and non-HBV infected subjects with normal liverfunction(n=12). The protein expression and tyrosine phosphorylation ofIRS-1in the hepatic tissues were detected by Western blotting.Results1.Higher serum insulin, ALT and HOMA-IR levels were seenin the MCHB patients [（12.76±7.98）uU/ml vs（7.34±3.10）uU/ml;（15.61±7.13）U/L vs（55.94±34.19）U/L;2.96±1.81vs1.61±0.69; P <0.001;P <0.001; P <0.001]and IR was seen in30(44.12%) patients.2.There were significant difference in ALT and BMI between the patients withIR and without IR（[66.40±32.85）U/L vs（47.47±32.87）U/L（;22.16±1.03）kg/m2vs（21.58±1.24）kg/m2; P=0.021，P <0.05].3. BMI and ALT weresignificant correlation with HOMA–IR in the MCHB（r=0.374;r=0.282;P<0.05）.But it seemed not to relate with the HBV DNA loads was not(r=0.015,p=0.904). Meanwhile, the positive independent related risk factorswere revealed by Binary Logistic regression analysis,including BMI andALT(P=0.001,P=0.015).4.In the liver tissues, compared with controlgroup, there was not significance difference in the protein expression andtyrosine phosphorylation of IRS-1in the MCHB subjects without IR（P>0.05），but those were significancely decreased in the MCHB subjectswith IR（P<0.05）.Conclusion There was high prevalence of insulin resistance in thepatients with mild hepatitis caused by chronic HBV infection, and theabnormal liver function and BMI were correlated with IR, HBV loads seemsnot to be associated with it. Declined in protein expression and tyrosinephosphorylation of IRS-1in liver maybe one of the mechanisms contributingto insulin resistance.