Preliminary Study Of Hepatic Insulin Resistance Induced By Hepatitis B Virus And Its Mechanism

Objected Liver was the vital organ of glycometabolism, and if its function had been damaged, the normal glycometabolism would be influenced. Data manifested, there were approximately 50-80% chronic hepatic disease patients presenting carbohydrate tolerance abnormality, and the prevalence rate of 2 diabetes mellitus in chronic viral hepatitis patients was 17.5%, but the prevalence rate of 2 diabetes mellitus in health adults was only 0.6%.It was discovered that parts of viral hepatitis patients would develop into hepatic failure because of blood glucose controlled failure, and the patients'life would be threatened severely. Length wise investigation confirmed, insulin resistance would had existed for 10-20 years before 2 diabetes mellitus taken place, so the best anticipation factor for 2 diabetes mellitus was insulin resistance. If pretreatments were carried out to those chronic viral hepatitis patients who had insulin resistance or had a tendency to develop to insulin resistance, the development of insulin resistance would be postponed even prevented, and living quality of patients could been improved obviously. To sum up, the study had significant theory and practical purpose to investigate the mechanism of insulin resistance induced by hepatitis B virus.Methods Type-specific primers were designed and used to genotype the HBV strains collected in Chongqing area by PCR,analyzing the relationship between HBV genotypes and insulin resistance; The serum of patients was collected before and after the antiviral therapy, the differences of the two groups were compared with FPG, Fins and HOMA-IR. The insulin receptor substrate 2 and internal reference primers were designed and used to analysis the expression difference in mRNA level of hepatic tissue among chronic hepatitis B patients with and without IR and health adults.Results Among the 130 HB patients, the insulin resistance rate of those who infected with genotype B virus was 27.47%, with genotype C was 28.57%, with genotype B and C was 18.18%, no genotype A, D, E, F, G, H viruses were found in this area. There was no statistical significance among the three founded genotypes. The degree of insulin resistance in 54 patients after antiviral therapy was lower than that of patients before antiviral therapy (P<0.05). Among 24 liver tissues, compared with control group, the expression of IRS-2 mRNA in hepatitis B patients without IR was decreased by 15.56%(P>0.05),and in hepatitis B patients with IR was decreased by 42.22%(P<0.05).Conclusion The patients infected with different HBV genotypes seemed not associated with their insulin resistance in Chongqing area. The degree of insulin resistance could be improved by antiviral therapy; Hepatitis B with IR seemed to be related with down-expression of IRS-2.