ABSTRACT
Objective:To investigate the changes of liver pathology and its influencing factors in patients with chronic hepatitis B viral (HBV) infection and low level of serum alanine aminotransferase (ALT).Methods:The clinical data of 135 with chronic HBV infection patients, in whom the serum ALT levels were less than two times of the upper limit of normal (ULN), were collected from the Affiliated Hospital of Medical School of Ningbo University and the First Affiliated Hospital, Zhejiang University School of Medicine during July 2017 and July 2019. The result of hepatic histological examination was reviewed, and the risk factors of obvious liver inflammation (G≥2) or fibrosis (S≥2) in patients were analyzed with Logistic regression analysis.Results:The pathological examination of liver tissue revealed G≥2 or S≥2 in 52 cases (38.5%). The univariate analysis showed that age, family history of HBV infection, ALT 1-<2×ULN, aspartate aminotransferase(AST)≥1×ULN, low platelet count(PLT)and prolongation of prothrombin time(PT)were associated with G≥2 or S≥2 in chronic HBV infection patients with low level ALT ( P<0.05 or <0.01). Multivariate Logistic regression analysis showed that age( OR=1.052, 95% CI 1.007-1.100), family history of HBV infection( OR=5.448, 95% CI 2.191-13.548)and AST( OR=1.042, 95% CI 1.005-1.081)were independent risk factors of G≥2 or S≥2 in chronic HBV infection patients with low level ALT ( P<0.05 or <0.01). Conclusion:Age, family history of HBV infection and AST level can be used to judge the severity of liver pathological changes and necessity of antiviral treatment for patients with chronic HBV infection having ALT<2×ULN.
ABSTRACT
Objective To investigate the changes of urine microalbuminuria(UMA) and serum C‐reactive protein(CRP) levels in patients with diabetic retinopathy(DR) and its significance .Methods A total of 152 type 2 diabetes mellitus(T2DM ) patients were included and 40 healthy individuals as normal controls(NC) .T2DM patients were divided into 3 groups ,65 patients with non‐dia‐betic retinopathy(NDR group) ,53 patients with non‐proliferative diabetic retinopathy(NPDR group) and 34 patients with prolifera‐tive diabetic retinopathy(PDR group) .UMA ,CRP and other clinical parameters were detect .Results The level of UMA and CRP increased progressively from NC ,NDR ,NPDR ,to PDR groups ,and there were significant differences among groups(P<0 .05) .The analysis of spearman rank correlation showed that UMA was positively associated with CRP(r=0 .311 ,P<0 .05) .UMA was also positively associated with the duration of diabetes ,fasting blood glucose(FBG) ,low density lipoprotein cholesterol(LDL‐C) ,hemo‐globin A1c(HbA1c) and homeostasis model assessment of insulin resistance(P< 0 .05) ,and CRP was also positively associated with the duration of diabetes ,FBG ,HbA1c and HOMA‐IR(P<0 .05) .Conclusion The development of DR is closely associated with kidney injury ,and chronic inflammation ,hyperglycemia and insulin resistance may be involved in the development and patho‐genesis of DR by interacting the renal function of T2DM patients .