| ObjectivesTo explore the relationships between the factors of metabolic, the serum TNF alpha as well as E-selectin and carotid artery intima thickness in patients with alcoholic liver disease and/or Helicobacter pylori infection, to provide the theoretical basis for prevention and cure to alcoholic liver disease and Helicobacter pylori infection. Methods152 cases in our hospital inpatient and outpatient physical examination were collected from January 2012 to December 2013. According to the diagnostic criteria of alcoholic fatty liver disease and the results of 13 C breath test, they were divided into four groups: 52 cases alcoholic fatty liver with Helicobacter pylori infection group(group A); 19 cases of Helicobacter pylori infection without alcoholic fatty liver group(group B) and 48 cases of alcoholic fatty liver disease without Helicobacter pylori infection group(group C) and 33 cases as control(group D)neither Helicobacter pylori infection nor alcoholic fatty liver group. The bilateral carotid intima-media thickness were measured by color ultrasound, and the serum Glu, UA, bilirubin, TNF alpha and E-selectin concentration were detected at the same time. Results(1) No statistical significance was found in the age among the four groups by One-Way ANOVA, F = 0.387, P = 0.762. There were no statistical difference(P > 0.05) between age of different groups.(2) Comparing to BMI among four groups has obvious statistical significance,F = 7.026, P = 0.000. The BMI in group A and group C was obviously higher than those of group D, P = 0.001 and 0.000, respectively. The BMI in group A is significantly increased than group B, P = 0.020. The BMI in group B was lower than that in group C, P = 0.005.(3) Comparing the CIMT among four groups had obvious statistical significance by one way, F = 3.802, P = 0.012.The CIMT in group A and group C was evidently thickened than those of group D, P = 0.002 and 0.017, respectively. But the CIMT in group B and group D were no difference, P = 0.520.(4) The contrast to the serum total bilirubin, direct bilirubin and indirect bilirubin levels among four groups by One-Way ANOVA and between the two groups in Post Hoc Multiple Comparisons had no statistical significance(P > 0.05).(5) Comparing the fasting glucose among four groups, there were no statistical significance, F = 2.156, P = 0.096. The fasting glucose between the two groups were no statistical difference(P > 0.05).(6) The contrast to the serum uric acid levels among four groups had significant statistical difference, F = 7.503, P = 0.000. The serum UA levels in group A and group C group were obviously higher than that of group D, P = 0.000 and 0.001 respectively. The serum UA level in group A was obviously bigger than that of group B, P = 0.002; The serum UA level in group B was lower than that in group C, P = 0.016. To compared group A with group C there was no statistical difference, P = 0.401.(7) The serum TNF alpha levels among four groups showed statistically significant, F = 5.967, P = 0.001.The serum TNF alpha levels in group A and group C were lower than those in group D, P = 0.023 and 0.048,respectively.And compared group B with group D, the serum TNF alpha levels showed no statistical difference, P = 0.098. Contrasted to group A, the serum TNF alpha levels in group B and group C showed no statistical difference, P = 0.980 and 0.997, respectively.(8) There was no significant statistical differences for the serum E–selectin levels among four groups, F = 2.356, P = 0.074.Compared to group D, the serum E-selectin levels in group A and group B and group C,there weren’t statistical difference, P = 0.355, 0.662 and 0.994,respectively. No statistical difference was seen between Group A and group B, P = 0.993, and between group B and group C, P = 0.686.(9) In group A the correlation between the CIMT with age(r = 0.469, P = 0.469), BMI(r = 0.560, P = 0.005), Glu(r = 0.455, P = 0.001) and UA(r = 0.350, P=0.350) were significantly positive correlation. In group B and group D the correlation between CIMT with age showed significantly positive correlation(r = 0.471,P = 0.041 and r = 0.619,P = 0.000, respectively). In group C the correlation between CIMT with UA(r = 0.338, P = 0.019) and E-selectin(r = 0.393, P = 0.006) had significantly positive correlation. Conclusions(1) Alcoholic liver disease or Hp infection with alcoholic liver disease can cause carotid intimal thickening, but the incrassation of carotid intima-media thickness wasn’t obvious in Helicobacter pylori infection only.(2) Overweight, metabolism disorder in blood sugar and blood uric was associated with alcoholic liver disease as well as Helicobacter pylori infection with alcoholic liver disease. And the latter was more serious, but alcoholic liver disease and/or Helicobacter pylori infection had nothing to do with the serum bilirubin levels.(3) TNF alpha in alcoholic liver disease or Hp infection with the alcoholic liver disease were significantly lower, but the change of E-selectin is not outstanding, the reason is not clear and need further study.(4) For all the cases in the study, the carotid intima thickness is associated with age. The increasement of carotid intima thickness in Hp infection with the alcoholic fatty liver has something to do with metabolic factors, but they have nothing to do with the serum TNF alpha level and the serum E-selectin level; and the increasement of carotid intima thickness in alcoholic fatty liver is related to blood uric acid and the serum E-selectin level. |
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