Clinical Features And Expressions Of Adiponectin, α-SMA Of Chronic Hepatitis B With Non-alcoholic Fatty Liver Disease In Yantai

ObjectiveTo research the clinical features in patients of chronic hepatitis B (CHB) with non-alcoholic fatty liver disease (NAFLD); To research the correlation between expressions of adiponectin(ADPN), α-smooth muscle actin(α-SMA) in the liver tissue and liver inflammation, fibrosis in CHB with NAFLD patients.MethodsPart Ⅰ:Measuring height and weight of all patients,94cases CHB with NAFLD (case group) and119cases CHB alone (control group), and their BMI values were calculated; The day of measuring, fasting venous blood samples were testde for liver biochemical indicators (ALT, TBIL, TCH, TG, LDLC, GLU) and virological (HBV-DNA,HBeAg) indicators.Part Ⅱ:94cases CHB with NAFLD(case group) and119cases simple CHB patients (control group) were performed liver biopsy under B-ultrasound-guided. Liver biopsy specimens were made into paraffin sections, HE and reticular fiber staining were performed to determine the degree of steatosis, inflammation and fibrosis. ADPN, α-SMA immunohistochemistry were performed, and the integral optical density (IOD) was measured. Further verify expressions of ADPN and α-SMA by immunoflu-orescence staining.Results1. Two groups are male-dominated patients; the proportions of male patients and obese patients in case group are significantly higher(P=0.007;P=0.018). Serum ALT level of case group is significantly higher than control group(P=0.001). TBIL level has no significant difference between the two groups(P=0.094). Quantitative HBV-DNA and HBeAg status between the two groups have no significant difference(P values>0.05). BMI level of case group is significantly higher than that of control group (P=0.01), especially male patients (P<0.001). TC, TG, LDLC and GLU levels of case group are significantly higher than that of control group (P<0.001, P<0.001, P=0.024, P=0.044).2. Proportions of liver inflammation and fibrosis in the two groups have no significant difference(P>0.05). Expressions of ADPN and a-SMA have no significant correlation with hepatic steatosis(R=0.032,R=0.098, P>0.346). The expression of ADPN in case group has not significantly correlated with the degree of inflammation and fibrosis(P>0.05); as contrary, the expression of ADPN has a negative correlation with the degree of inflammation and fibrosis(R=-0.223, R=-0.259;P<0.05). the expression of a-SMA in case group has positively correlated with the degree of inflammation and fibrosis (R=0.323,R=0.355,P<0.05); the control group also showed a positive correlation, but correlation is not obviously, and there is no statistically significan(P>0.05).Conclusion1. The occurrence of NAFLD is mainly related to metabolic factors, unrelated to the virus;2. NAFLD may promote the progress of liver damage in patients with CHB;3. ADPN is not directly related with liver injury in patients of CHB with NAFLD;4. a-SMA may be important indicator to determine the degree of liver inflammation and fibrosis in patients of CHB with NAFLD.