关键词: 慢性乙型肝炎, 肝炎病毒, 非酒精性脂肪性肝病, 脂联素, 反应性氧化物, 血糖, 血脂

Abstract: Objective To analyze the characteristics of serum adiponectin (APN), reactive oxygen species (ROS), and glucose-lipid metabolism in patients with chronic hepatitis B virus (HBV) infection combined with non-alcoholic fatty liver disease (NAFLD). Methods Between April 2022 and April 2024, a total of 172 patients were enrolled, including those with chronic HBV infection (HBV group, 61 cases), NAFLD (NAFLD group, 26 cases), and chronic HBV infection combined with NAFLD (HBV+NAFLD group, 85 cases) . Clinical data were analyzed, and serum levels of APN, ROS, and glucose-lipid metabolism indicators_fasting blood glucose (FPG), fasting insulin (FINS), Homeostasis model assessment of insulin resistance(HOMA-IR), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triglycerides (TG)-were measured. Liver function andfibrosis markers, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), hyaluronic acid (HA), laminin (LN), type III procollagen peptide (PIIIP), and type IV collagen (CIV), were also assessed. Results The FINS, HOMA-IR, TC, and TG levels in the NAFLD group were (16.31±2.64) μIU/L,(4.08±0.69), (5.22±1.23) mmol/L, and (2.05±0.73) mmol/L respectively, In the HBV+NAFLD group, these values were (16.14±2.58) μIU/L, (4.09±0.71), (4.72±1.21) mmol/L, and (1.76±0.38) mmol/L respectively. Both the NAFLD and HBV+NAFLD groups showed significantly higher values compared to the HBV group, which had FINS, HOMA-IR, TC and TG levels of (9.03±1.25) μIU/L, (2.18±0.33), (4.31±0.82) mmol/L, and (1.16±0.32) mmol/L, respectively (P<0.05). However, no significant differences were observed between the NAFLD and HBV+NAFLD groups (P>0.05). There were no statistically significant differences in ALT, AST, HA, LN, P Ⅲ P, or CⅣ levels among the three groups (P>0.05). The ROS levels in the NAFLD group and HBV+NAFLD group were (2.05±0.43) U/mL and (1.89±0.38) U/mL respectively, both significantly higher than the HBV group at (0.91±0.24) U/mL (P<0.05). The APN levels in the NAFLD and HBV+NAFLD groups were (8.02±1.15) ng/mL and (8.47±1.26) ng/mL, respectively, significantly lower than the HBV group at (10.14±2.33) ng/mL (P<0.05). However, no statistically significant differences in ROS and APN levels were observed between the HBV+NAFLD and NAFLD group (P>0.05). Conclusion Low APN expression elevated ROS levels, and abnormal glucose-lipid metabolism may contribute to the progression of chronic HBV infection combined with NAFLD.

Key words: Chronic hepatitis B, Hepatitis virus, Non-alcoholic fatty liver disease, Adiponectin, Reactive oxides, Blood sugar, Blood fat