| Hepatitis C virus(HCV) infection is the major cause of hepatitic cirrhosis and carcinoma, also one of the major health problems in the world.HCV were thought to be hepatotropic and pantropic.Chronic Hepatitis C(CHC) is a kind of metabolic syndrome, apart from the damage to the liver itself, it can also lead to a wide spectrum of extrahepatic manifestations. According to the reports, about 40-76% CHC patients had at least one kind of extrahepatic organ or tissue affected, even some patients firstly went to the hospital for extrahepatitic manifestations. In recent years, a large number studies had found HCV infection was a risk factor of atherosclerosis. HCV can promote the occurrence and development of atherosclerosis, leading to cardiovascular and cerebrovascular diseases.The pathogenesis of atherosclerosis was complex in CHC,and had not been fully elucidated. Some researches showed that HCV infection may promote atherosclerosis through some direct or indirect biological mechanisms. The liver related gluco-lipid metabolic disorders, the proliferation and replication of HCV in the arterial wall, liver related steatosis and fibrosis, oxidative stress reaction, the unbalanced secretion of inflammatory cytokine,insulin resistance and so on, a variety of potential mechanisms can synergistically promote the occurrence and development of atherosclerosis. In recent years, the study found that visceral adipose tissue was not only the organ for the body to store energy, but also an active endocrine organ which could secrete a variety of bioactive adipocytokines. As gradually rising studies on adipocytokines, we found there was a close relationship between adipocytokines and atherosclerosis.Visfatin, a newly identified adipocytokine, was mainly expressed in visceral adipose tissue. It had various biological functions and was animportant signal molecule in the gluco-lipid metabolism, insulin resistance and metabolic syndrome. A number of studies had found that visfatin was closed with impaired endothelial function, angiogenesis, the formation of vulnerable plaques, vascular smooth muscle proliferation and degeneration, and so on. The relation between visfatin and atherosclerosis had become a hot topic. Anterial intima was firstly affected in atherosclerosis, and the thickened carotid Intima-media thickness(CIMT) and the formation of artery plaque were considered to be an early sign of atherosclerosis, so in our study we chose CIMT as the evaluation index of atherosclerosis in CHC patients.The studies had found visfatin was closely related to atherosclerosis,however the studies on the association between visfatin and atherosclerosis in CHC was less at home.In this article through the ultrasound examination in CHC patients, we would preliminary screen the incidence of atherosclerosis, and explore the correlation of visfatin and CIMT and the indicators of CHC patients,to explore the correlation of visfatin and atherosclerosis in CHC patients and provide new thingking for the prevention and treatment of atherosclerosis in CHC patients.Objective: In this article, through the measurement for the levels of visfatin and CIMT of CHC patients, we would preliminary explore the incidence of atherosclerosis and the correlation between visfatin and atherosclerosis in CHC patients, to provide new thingking for the prevention and treatment of atherosclerosis in CHC patients.Methods: 1 Subjects: 46 CHC patients in Hebei General Hospital who were incorporated into and exclusion criteria from January to December in 2014 were recruited as experimental group. 40 healthy people with gender, age and BMI mached in Hebei General Hospital physical examination center over the same time were recruited as control group. 2 Groups: According to the results of carotid ultrasound, the experimental group was divided into 2 groups, 20 CHC cases with thickened CIMT as CIMT thickened group, 26 CHC cases with normal CIMT as CIMT normalgroup. 3 Meathods: ⑴ Record the general information, history, and routine checkups of all subjects. After an overnight fast, blooding samples were collected from subjects to measure HCV-RNA viral load, liver function, blood sugar and lipid metabolism indexes. Serum samples were separated by centrifuging at 3000 r/min for 15 minutes and were stored at-80℃ until analysis. ⑵ Statistic analysis: Compare the clinical data and serum visfatin between experimental and control group; compare the clinical data and serum visfatin between CIMT thickened group and CIMT normal group. Relationships between variables were tested using simple(pearson’s correlation coefficient) linear regression analysis and multiple linear regression analysis.Results: 1 The comparison of cilinical data 1.1 The comparison of cilinical data between experimental and control group Physiological variables: The gender, age and BMI were matched between two groups. The levels of SBP and DBP between the two groups were no difference. Biochemical variables: The levels of ALT, AST and GGT in experimental group were significantly higher than those in control group(P<0.05).The levels of HDL, TC and TG in experimental group were significantly lower than those in control group(P <0.01).The levels of FPG, LDL and TBil between the two groups were no difference. 1.2 The comparison of CIMT between experimental and control group The level of CIMT in experimental group was higher than that in control group(1.00±0.29vs0.83±0.31; P<0.05).The incidence of abnormal CIMT in experimental group was higher than that in control group(43.48% vs 20.00%; P<0.05). 1.3 The comparison of cilinical data between CIMT thickened group and CIMT normal groupPhysiological variables: The levels of age and SBP in CIMT thickened group were higher than than in CIMT normal group(P <0.05). The levels of BMI and DBP between the two groups were no difference. Biochemical variables: The levels of HDL in CIMT thickened group were higher than in CIMT normal group(P <0.05). The levels of ALT、AST、GGT、TBil、FPG、LDL、TC、TG、HCV-RNA between the two groups were no difference. 2 The comparison of serum visfatin 2.1 The level of serum visfatin(42.89±18.63 ng/m) in experimental group was significantly higher than that(27.02±13.14ng/ml) in control group(P <0.001). 2.2 The level of serum visfatin(55.06±15.72ng/ml) in CIMT thickened group was significantly higher than that(33.54±15.09ng/ml) in CIMT normal group(P <0.001). 3 The Pearson correlation between serum visfatin, CIMT and other variables in experimental group 3.1 There were a positive correlation between serum visfatin and age(P <0.01),BMI(P <0.05),SBP(P <0.05),FPG(P <0.05),TG(P <0.01)and CIMT(P <0.001).There were no correlation between visfatin and other variables. 3.2 There were a positive correlation between CIMT and age(P <0.01), SBP(P <0.05), FPG(P <0.05), HDL(P <0.05), TG(P <0.05) and serum visfatin(P<0.001). There were no correlation between visfatin and other variables. 4 Multiple stepwise regression analysis 4.1 Visfatin as dependent variable, age, BMI, SBP, FPG, TG and CIMT as independent variables, multiple stepwise regression analysis showed that BMI(β=0.793, P <0.001)and CIMT(β=0.153, P =0.079) were the independent risk factors of visfatin in CHC. Regression equation:Y=50.518*CIMT +0.908* BMI-30.378(R2=0.700, P <0.001). 4.2 CIMT as dependent variable, age, SBP, FPG,HDL,TG and serum visfatin as independent variables, multiple stepwise regression analysis showed that visfatin was the independent risk factor of CIMT in CHC. Regression equation:Y=0.013*visfatin+0.450(R2=0.677, P <0.001).Conclusions: 1 The morbidity of abnormal carotid Intima-media thickness was 44%, higher than the control group, and CHC could be considered to be a risk factor of atherosclerosis. 2 The level of serum visfatin in CHC patients was increased compared with the control group, and the level of serum visfatin was increased in CHC patients with thickened CIMT compared with the normal CIMT ones, and visfatin was closely related to atherosclerosis in CHC patients. |
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