PMID- 31698809
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 8
IP  - 11
DP  - 2019 Nov 6
TI  - Insulin Resistance Associated Disorders Pivoting Long-Term Hepatitis B Surface 
      Antigen Decline During Entecavir Therapy.
LID - 10.3390/jcm8111892 [doi]
LID - 1892
AB  - Insulin resistance associated disorders (IRAD), including prediabetes, type 2 
      diabetes mellitus (T2DM), and fatty liver are significant risk factors of 
      liver-related death in chronic hepatitis B (CHB). However, their relationship 
      remains unclear. We aimed to evaluate how IRAD influence the kinetics of serum 
      hepatitis B surface antigen (HBsAg) in patients with CHB during long-term 
      entecavir treatment. We enrolled 140 patients with CHB receiving at least 3 years 
      of consecutive entecavir treatment in this retrospective study. A linear mixed 
      effects model was adopted to examine the effects of variables and their 
      interaction over time on the HBsAg trajectory. Furthermore, we acquired cytokine 
      profiles and baseline fibrosis-4 index (FIB-4) scores for in-depth analysis. The 
      median treatment time was 6.90 (4.47-9.01) years. Multivariate analysis revealed 
      that older patients or those with prediabetes or T2DM had a significantly slower 
      HBsAg decline over time (p = 0.0001 and p < 0.0001, respectively). Conversely, 
      advanced fatty liver engendered a more rapid HBsAg decrease (p = 0.001). Patients 
      with prediabetes or T2DM possessed higher IP-10 levels six years after entecavir 
      therapy (p = 0.013). Compared to patients without prediabetes or T2DM, diabetic 
      patients had more unfavorable features at the baseline, especially higher FIB-4 
      scores. Prediabetes or T2DM delays the clearance of HBsAg, but advanced hepatic 
      fatty change counterbalances the effect. Additionally, IRAD could cause hepatic 
      sequelae in CHB through immune-metabolic pathways.
FAU - Lin, Tien-Ching
AU  - Lin TC
AD  - Department of Internal Medicine, National Cheng Kung University Hospital, College 
      of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
AD  - Institute of Clinical Medicine, College of Medicine, National Cheng Kung 
      University, Tainan 704, Taiwan.
FAU - Liu, Wen-Chun
AU  - Liu WC
AD  - Infectious Disease and Signaling Research Center, National Cheng Kung University, 
      Tainan 701, Taiwan.
FAU - Hsu, Yu-Hsiang
AU  - Hsu YH
AD  - Institute of Clinical Medicine, College of Medicine, National Cheng Kung 
      University, Tainan 704, Taiwan.
AD  - Clinical Medicine Research Center, National Cheng Kung University Hospital, 
      College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
FAU - Lin, Jia-Jhen
AU  - Lin JJ
AD  - Department of Internal Medicine, National Cheng Kung University Hospital, College 
      of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
FAU - Chiu, Yen-Cheng
AU  - Chiu YC
AD  - Department of Internal Medicine, National Cheng Kung University Hospital, College 
      of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
FAU - Chiu, Hung-Chih
AU  - Chiu HC
AD  - Department of Internal Medicine, National Cheng Kung University Hospital, College 
      of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
FAU - Cheng, Pin-Nan
AU  - Cheng PN
AD  - Department of Internal Medicine, National Cheng Kung University Hospital, College 
      of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
FAU - Chen, Chiung-Yu
AU  - Chen CY
AD  - Department of Internal Medicine, National Cheng Kung University Hospital, College 
      of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
FAU - Chang, Ting-Tsung
AU  - Chang TT
AD  - Department of Internal Medicine, National Cheng Kung University Hospital, College 
      of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
AD  - Institute of Clinical Medicine, College of Medicine, National Cheng Kung 
      University, Tainan 704, Taiwan.
AD  - Infectious Disease and Signaling Research Center, National Cheng Kung University, 
      Tainan 701, Taiwan.
AD  - Clinical Medicine Research Center, National Cheng Kung University Hospital, 
      College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
FAU - Wu, I-Chin
AU  - Wu IC
AD  - Department of Internal Medicine, National Cheng Kung University Hospital, College 
      of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
AD  - Infectious Disease and Signaling Research Center, National Cheng Kung University, 
      Tainan 701, Taiwan.
LA  - eng
PT  - Journal Article
DEP - 20191106
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC6912775
OTO - NOTNLM
OT  - chronic hepatitis B
OT  - diabetes mellitus
OT  - fatty liver disease
OT  - nucleos(t)ide analogs
COIS- The authors declare no conflict of interest.
EDAT- 2019/11/09 06:00
MHDA- 2019/11/09 06:01
PMCR- 2019/11/06
CRDT- 2019/11/09 06:00
PHST- 2019/09/23 00:00 [received]
PHST- 2019/10/22 00:00 [revised]
PHST- 2019/11/04 00:00 [accepted]
PHST- 2019/11/09 06:00 [entrez]
PHST- 2019/11/09 06:00 [pubmed]
PHST- 2019/11/09 06:01 [medline]
PHST- 2019/11/06 00:00 [pmc-release]
AID - jcm8111892 [pii]
AID - jcm-08-01892 [pii]
AID - 10.3390/jcm8111892 [doi]
PST - epublish
SO  - J Clin Med. 2019 Nov 6;8(11):1892. doi: 10.3390/jcm8111892.