The Study On The Relationship Between HBV/HCV Related Liver Disease And Annormal Glucose Metabolism And Insulin Resistance

Objective : This topic research purpose is understanding of HBV/HCV mingle related chronic liver disease and carbohydrate metabolism and insulin resistance. To investigate the relationship between insulin resistance distribution in chronic liver disease, effects of insulin resistance on the prognosis of the patients to remind clinicians in chronic liver disease indexes of glucose metabolism abnormal and be timely intervention, for clinical prevent hepatic diabetes and hepatic insulin resistance occurs and provide a theoretical basis.Methods:1.Collected 189 cases of our hospital liver ill division and department of Gastroenterology,chronic HBV/HCV mingle infection on November 30, December 2013 to 2015 period, 100 cases of HBV, 89 cases of HCV, in accordance with no blood glucose abnormalities were divided into two groups, elevated blood sugar 106 cases of patients, 83 cases of patients with normal blood glucose, and two groups in gender, age and MBI had no significant difference(P>0.05). All patients had positive HBV or HCV markers. Before entering the group did not receive any hypoglycemic treatment, no history of alcohol abuse, no diabetes complications, heart function, kidney function is normal. Completion of the observation of anti viral treatment for three months in the treatment of patients in the course of the treatment did not receive any hypoglycemic therapy. 2.All patients in the early morning of venous blood, glucose by hexokinase method, glycosylated hemoglobin(Hb A1c) by competitive imm--unosuppressive turbidimetry assay, liver function, blood lipid use automatic biochemical analyzer determination. Insulin and C peptide were determined by the electrochemical luminescence method. The four items of liver fiber were determined by the method of luminescence immunoassay. Detection of HBV/HCV viral load by PCR.Result:1.Blood glucose rise group, serum AST, ALT, TG, TC were significantly higher than the normal blood glucose group, ALB was lower than the normal blood glucose group, and were statistically significant(P<0.0 5). And serum TBIL, GLB, A/G, LDL-C, TBA, HDL-C in the two groups were not statistically significant difference between the groups. 2.IR distribution characteristics: the incidence of B and C genotype IR was not statistically significant(P>0.05) in HBV infected persons. 1B type HCV infection in the incidence of IR was significantly higher than others, and has a statistically significant difference(P<0.05). 3.The relationship between IR and viral load: HBVDNA, HCVRNA and HOMA-IR had positive correlation(P<0.05) in HBV and HCV infected persons. The value of IR changes with the change of viral load after antiviral therapy. 4.Serum HA, IV-C and IR values were positively correlated with in patients with chronic hepatitis. 5.Hepatic encephalopat--hy, primary liver cancer and infection occurred in patients with cirrhosis. The regression coefficients were positive, which were 3.795, 2.716, 1.169, OR value was more than 1, and the difference was statistically significant(P<0.05).Conclusion : 1.Chronic hepatitis patients with serum AST,ALT, TG, TC continued to rise, ALB significantly decreased when the need to be alert to the occurrence of liver derived diabetes. 2.HCV infected persons in the gene type 1b is more likely to appear insulin resistance. 3. Chronic hepatitis B patients serum HA and IV-C detection to predict the occurrence of insulin resistance has adjuvant effect. IR in patients with cirrhosis of the liver encephalopathy, liver cancer and infection appear to have a certain role in promoting.