The Clinical Significance Of Peripheral Blood BMP9 And Ferritin Levels In Chronic HBV Infection And Nonalcoholic Fatty Liver Disease

Objective:1.The observation of peripheral blood BMP9(bone morphogenetic protein9),and ferritin levels in the patients of different groups,included simple hepatitis B virus(HBV)infection group,HBV infection combined with nonalcoholic fatty liver disease(NAFLD)group,and simple NAFLD group.2.Comparison of peripheral blood BMP9 and ferritin levels in patients of different groups,included the group of HBV infection combined with nonalcoholic simple fatty liver(NAFL),the group of HBV infection combined with nonalcoholic steatohepatitis(NASH),the group of pure NAFL,the group of pure NASH,analysis whether they are associated with the severity of NAFLD,whether to help the differentiate the reasons of mild abnormal liver function of patients with HBV infection combined with NAFLD.3.To explore the relationship among the peripheral blood BMP9,ferrtin levels and liver fibrosis Methods:Since May 2017 to January 2018 collecting cases from inpatients of Tianjin second people's hospital affiliated to Nankai university,and continuous included 127 patients,including simple HBV infection group(36 cases),HBV infection with NAFLD group(51 cases),pure NAFLD group(20 cases).In addition,healthy control group(20 cases)were recruited in the staff of the hospital.Testing the levels of peripheral blood BMP9 and ferritin,and analysis and comparison the difference of different groups,and their relationship with hepatic fibrosis.Result:1.The research objects of this research enrolled into a total of 147 cases,including simple HBV infection group 36 cases(36/147,24.49%),HBV infection with NAFLD group 51 cases(51/147,34.69%),pure NAFLD group 40 cases(40/147,27.21%),normal group 20 cases(20/147,13.61%).All the object of study in78 cases of male,female 69 cases,aged 17-66,the average age was 33.04± 11.21 years old.2.The peripheral blood BMP9 levels of patients increase in pure NAFLD group,normal control group,HBV infection combined with NAFLD group,simple HBV infection group,and statistically significant(P < 0.001).With no statistical difference between the pure NAFLD group and normal group,the two remaining both arestatistically significant.The peripheral blood ferritin levels of petients increase in the normal group,HBV infection combined with NAFLD group,pure NAFLD group,and simple HBV infection group,and statistical significance(P < 0.001).With no statistical difference between HBV infection with NAFLD group and pure NAFLD,the two remaining both are statistically significant.3.According to the NAFLD activity score(NAS)of liver pathology,patients of pure NAFLD group(40 cases)were divided into pure NAFL group(19 cases)and pure NASH group(21 cases).Observed peripheral blood BMP9,ferritin levels in the normal group,the pure NAFL group,pure NASH group.The results shows that peripheral blood BMP9 levels increased in pure NASH group,pure NAFL group and normal group.That of pure NASH group and pure NAFL group was statistically difference,and that of pure NASH group and normal group was statistically difference,with on statistic difference between that of pure NAFL group and normal group.Peripheral blood ferritin levels increased in normal group,pure NAFL group and pure NASH group.That of normal group and pure NAFL group was no statistically difference,and that of normal group and pure NASH group was statistically difference,and that of pure NAFL group and pure NASH group was statistically difference.4.According to the NAFLD activity score(NAS)of liver pathology,patients of HBV infection with NAFLD group(51 cases)were divided into HBV infection with NAFL group(27 cases)and HBV infection with NASH group(24 cases).Observed peripheral blood BMP9,ferritin levels in the simple HBV infection group,HBV infection with NAFL group,HBV infection with NASH group.The results shows that peripheral blood BMP9 levels increased in HBV infection with NASH group,HBV infection with NAFL group and simple HBV infection group.That of HBV infection with NASH group and HBV infection with NAFL group was statistically difference,and that of HBV infection with NASH group and simple HBV infection group was statistically difference,with on statistic difference between that of HBV infection with NAFL group and simple HBV infection group.Peripheral blood ferritin levels increased in HBV infection with NAFL group,HBV infection with NASH group and simple HBV infection group.That of HBV infection with NAFL group and HBV infection with NASH group was no statistically difference,and that of HBV infection with NAFL group and simple HBV infection group was statistically difference,and that of HBV infection with NASH group and simple HBV infection group was statistically difference.5.According to liver function of patients was normal or not,the patients in HBV infection with NAFLD group were(51 cases)divided into normal liver function group(12 cases)and abnormal liver function group(39 cases),in which caused abnormal liver function by NAFLD were 14 cases,in with caused by HBV were 15 cases,in which caused by HBV and NAFLD group were 10 cases.Observed of peripheral blood BMP9,iron protein expression levels in the above groups.The peripheral blood BMP9 levels of HBV infection with NAFLD patients was significant statistical difference among normal liver function group and abnormal liver function group.And they increased in abnormal liver function caused by NAFLD group,normal liver function and abnormal liver function caused by HBV.The peripheral blood ferritin levels of HBV combined with NAFLD patients was no statistical difference among normal liver function group and abnormal liver function group.6.According the severity of liver fibrosis,the patients in simple HBV infection group were divided into S0(7case,7/36,19.44%),S1(11case,11/36,30.56%),S2(11case,11/36,30.56%),S3(7 case,7/36,19.44%),and the levels of peripheral blood BMP9 and serum ferritin were increased with the progress of liver fibrosis.The level of peripheral blood BMP9 and liver fibrosis were positively correlated,r = 0.363,P <0.001,and the level peripheral blood ferritin and liver fibrosis were positively correlated,r = 0.246,P < 0.001.Conclusion:Part One The clinical significance of peripheral blood BMP9 and ferritin levels in chronic HBV Infection with nonalcoholic fatty liver disease1.Peripheral blood BMP9,ferritin levels may be closely related to NAFLD,and peripheral blood BMP9 reduced with the aggravation of NAFLD,and serum ferritin increased with the aggravation of NAFLD.2.Peripheral blood BMP9,serum ferritin expression level were closely related to HBV infection.3.Peripheral blood BMP9 was helpful to distinguish the reasons of liver dysfunction of patients in HBV infection with NAFLD.Part Two The relationship of peripheral blood BMP9,ferritin levels and liver fibrosisPeripheral blood BMP9,ferritin levels may be closely related to liver fibrosis.