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Objective To investigate the correlation between serum level of insulin growth factor 1 (IGF-1) and the degree of liver fibrosis in patients with chronic hepatitis C (CHC) complicated to type 2 diabetes mellitus (T2DM). Methods The cases were divided into CHC with T2DM (39 cases), CHC (96 cases), T2DM (60 cases), and healthy control (60 cases) groups. Their human data were collected and the fasting blood glucose, insulin and insulin-like growth factor-1 levels were detected, and the insulin resistance index ( HOMA-IR) wwer calculated. The serum levels of alanine transaminase ( ALT) , aspartate transaminase ( AST) , hepatitis C virus ( HCV) RNA load and HCV genotypes were detected simultaneously in patients with hepatitis C, and liver stiffness were measured ( LSM) by transient elastography ( TE) and aspartate aminotransferase-to-platelet ratio index ( APRI) score was performed. Results ⑴ There was no significant difference between CHC with T2DM group and CHC group in diabetes family history(P>0. 05), but two groups were significantly lower than that of T2DM group (P<0. 05). ⑵The levels of fasting insu-lin (FI) and HOMA-IR in CHC with T2DM group and T2DM group were significantly higher than those in the other two groups (P<0. 05), while the levels of IGF-1 in two groups were significantly lower than those in the CHC group, and were more lower than the control group (P<0. 05). ⑶Compared the serum ALT, AST and HCV RNA load between CHC with T2DM group and CHC group, there had no significant differ-ence (P>0. 05);however, the proportion of 1b genotype, LSM and APRI score of CHC with T2DM group were significantly higher than those in CHC group(P<0. 05). ⑷ The level of serum IGF-1 was negatively correlated with HOMA-IR, LSM and APRI in CHC with T2DM group (r= -0. 71, -0. 75, -0. 69, P<0. 01). Conclusions The degree of hepatic fibrosis and the damage of IGF-1 synthesis in CHC patients with T2DM were significantly higher than those in non T2DM patients, which might be related to the insulin resistance caused by 1b genotype HCV infection.
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Objective To investigate whether C-reactive protein (CRP) and neutrophil/lymphocyte ration (NLR) can predict the infection complications and predict the short-term survival rate of patients with cirrhosis.Methods Data of 208 patients with liver cirrhosis from March 2013 to March 2016 were analyzed retrospectively.The effects of CRP concentration,NLR and other clinical factors on the infection and one-month survival rate of patients with liver cirrhosis were analyzed.Results Sixty-five patients with dominant infection during hospitalization were used as the infected group,while the other 143 patients were selected as uninfected group.The levels of CRP and NLR in the infected group were significantly higher than those in the uninfected group (CRP:t =16.216,P =0.003;NLR:t =7.211,P =0.025).The results of univariate analysis showed that age,female,non-alcoholic cirrhosis,systemic inflammatory response syndrome (SIRS),high level of CRP,and high NLR value were important risk factors of infection in cirrhotic patients.In multivariate analysis,female,high level of CRP,and high NLR value were the independent predictor of infection in patients with cirrhosis.Univariate analysis showed that NLR,model for end-stage liver disease (MELD) score,and WBC count were important predictors of 1-month survival.Multivariate analysis showed that high NLR was an independent predictor of one-month survival in Child Pugh C patients.Conclusions CRP level and NLR value may be an effective diagnostic marker in patients with liver cirrhosis.The high NLR value in patients with Child-Pugh C is an independent risk factor for poor short survival.
RESUMO
Objective To investigate whether C-reactive protein (CRP) and neutrophil/lymphocyte ration (NLR) can predict the infection complications and predict the short-term survival rate of patients with cirrhosis.Methods Data of 208 patients with liver cirrhosis from March 2013 to March 2016 were analyzed retrospectively.The effects of CRP concentration,NLR and other clinical factors on the infection and one-month survival rate of patients with liver cirrhosis were analyzed.Results Sixty-five patients with dominant infection during hospitalization were used as the infected group,while the other 143 patients were selected as uninfected group.The levels of CRP and NLR in the infected group were significantly higher than those in the uninfected group (CRP:t =16.216,P =0.003;NLR:t =7.211,P =0.025).The results of univariate analysis showed that age,female,non-alcoholic cirrhosis,systemic inflammatory response syndrome (SIRS),high level of CRP,and high NLR value were important risk factors of infection in cirrhotic patients.In multivariate analysis,female,high level of CRP,and high NLR value were the independent predictor of infection in patients with cirrhosis.Univariate analysis showed that NLR,model for end-stage liver disease (MELD) score,and WBC count were important predictors of 1-month survival.Multivariate analysis showed that high NLR was an independent predictor of one-month survival in Child Pugh C patients.Conclusions CRP level and NLR value may be an effective diagnostic marker in patients with liver cirrhosis.The high NLR value in patients with Child-Pugh C is an independent risk factor for poor short survival.