Correlation of the levels of angiotensin II and angiotensin (1-7) with the degree of chronic hepatitis B liver fibrosis / 临床肝胆病杂志

ABSTRACT

@#ObjectiveTo investigate the differences in the plasma levels of angiotensin II (Ang II) and angiotensin (1-7) ［Ang(1-7)］ in different stages among patients with chronic hepatitis B (CHB) liver fibrosis and their significance in the pathogenesis of liver fibrosis. MethodsA prospective study was performed. A total of 86 patients with hepatitis B virus (HBV) infection who attended our hospital from March 2017 to March 2019 were enrolled and divided into CHB group (group A) with 25 patients, compensated hepatitis B cirrhosis group (group B) with 31 patients, and decompensated hepatitis B cirrhosis group (group C) with 30 patients. The double-antibody sandwich method was used to measure the plasma levels of Ang II and Ang(1-7), and FibroTouch scan was used for liver stiffness measurement (LSM). A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t-test was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups. A binary linear correlation analysis was used to investigate the correlation of the plasma levels of Ang II and Ang(1-7) with LSM; a Spearman rank correlation analysis was used to investigate the correlation of the plasma levels of Ang II and Ang(1-7) with the progression of CHB liver fibrosis; a logistic regression analysis was used to evaluate the value of Ang II, Ang(1-7), and LSM in predicting hepatitis B cirrhosis. ResultsWith the progression of liver fibrosis from group A to group C, there was a significant increase in course of disease (5.2±1.3 years vs 7.8±1.6 years vs 10.1±1.5 years, F=4.266, P=0.002), a significant reduction in the proportion of patients receiving antiviral therapy (76.00% vs 64.52% vs 53.33%, χ２=5.544, P＜0.001), significant increases in Ang II (51.01±868 pg/ml vs 74.38±10.05 pg/ml vs 102.78±13.22 pg/ml, F=520.260, P<0.001), Ang II/Ang(1-7) ratio (1.06±0.41 vs 232±023 vs 5.82±1.24, F=18.860, P＜0.001), and LSM (6.85±1.26 kPa vs 18.25±3.22 kPa vs 26.84±7.57 kPa, F=93.260, P＜0001), and a significant reduction in Ang(1-7) (45.93±10.24 pg/ml vs 31.52±9.62 pg/ml vs 16.55±9.48 pg/ml, F=209.860, P＜0001). Ang II and Ang II/Ang(1-7) ratio were positively correlated with LSM (r=0.623 and 0.813, both P＜0.01), while Ang(1-7) was negatively correlated with LSM (r=-0.677, P＜0.01). Ang II, Ang II/Ang(1-7) ratio, and LSM gradually increased with the progression of liver fibrosis (r=0639, 0.886, and 0.712, all P＜0.01), while Ang(1-7) was negatively correlated with the progression of liver fibrosis (r=-0.653, P＜0.01). Ang II/Ang(1-7) ratio and LSM had an early warning effect for liver cirrhosis in patients with HBV infection (odds ratio=1884 and 2.015, both P＜0.01). ConclusionIn patients with HBV infection, there are gradual increases in Ang II and Ang II/Ang(1-7) ratio and a gradual reduction in Ang(1-7) with the aggravation of liver fibrosis. Dynamic monitoring of the plasma levels of Ang II and Ang(1-7) can provide a reference for real-time assessment of liver fibrosis and decision-making in clinical diagnosis and treatment.