肝炎病毒感染与胰岛素抵抗

肝炎病毒慢性持续感染主要是由乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)所致, 除了引起肝脏损害外, 还与一些肝外组织的损害密切相关. 近年来, 研究资料显示慢性HCV和HBV感染与糖尿病和脂肪肝等代谢性疾病的发病密切相关, 而胰岛素抵抗(IR)可能是其发病机制的中心环节. IR也是肝纤维化进展的相关因素, 并影响慢性肝炎病毒感染时抗病毒治疗的疗效. 此外, 糖尿病还可能增加肝炎病毒致癌的作用, 应该引起肝病医师的高度重视. 本文就近年来对HCV和HBV感染中IR发生机制方面的研究, IR在HCV和HBV感染相关的糖尿病和脂肪肝中的作用和影响及其对临床的指导意义作一述评.

Hepatitis virus infection and insulin resistance

Extrahepatic tissues, as well as liver damage, is involved in hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Recent studies suggest that chronic HBV and HCV infections are correlated with metabolic diseases such as diabetes mellitus and fatty liver. Insulin resistance plays a critical role in hepatitis-virus-related metabolic diseases, and may facilitate the progression of hepatic fibrosis and influence the efficacy of antiviral therapy. Diabetes mellitus may increase the risk of developing hepatocellular carcinoma. Thus, careful attention needs to be paid to insulin resistance and metabolic diseases associated with chronic HBV and HCV infections.