Disorders of carbohydrate-lipid metabolism and galectin-3 level as factors of liver fibrosis progression in chronic hepatitis C

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Abstract

Aim. To assess the effect of metabolic disorders and galectin-3 levels on the progression of liver fibrosis in chronic hepatitis C.

Materials and methods. 106 patients with HCV without decompensated liver cirrhosis were examined. Exclusion criteria: age younger than 20 and older than 65 years, diabetes, coronary heart disease, hypertension, alcoholism, drug addiction. Laboratory examination (biochemical blood test, enzyme immunoassay (ELISA) with determination of HCV-Ab antibodies, viral load) was supplemented with liver elastometry (Fibroscan®) with fibrosis assessment (kPa, METAVIR scale). The body mass index of Quetelet (kg/m2), the presence of abdominal obesity, insulin resistance were evaluated. Serum levels of insulin and galectin-3 were determined by ELISA.

Results. In 45% of patients, an increase in ITM was revealed, in 44% – abdominal obesity, in 62% – insulin resistance. In 75% abdominal obesity was determined in patients with liver fibrosis F3–F4. Insulin resistance was found more often in patients with fibrosis F0–1 – 56.7%. Significant correlations between the level of galectin-3 and the degree of liver fibrosis (in kPa) [r=0,206, p=0,034], as well as the stage of liver fibrosis (on the METAVIR scale) [r=0,247, p=0,01] were obtained. The level of galectin-3 in liver cirrhosis was 6.32 (4.57; 9.64) ng/ml, which is significantly higher than in F0 – 3.96 (1.45; 5.30) ng/ml (p=0.002) and F1 – 3.85 (2.20; 5.83) ng/ml (p=0.002). By calculating the specificity and sensitivity of isolated for F4 stage of liver fibrosis (ROC-curve, the level of galectin-3 is 5.21 ng/ml), the level of specificity of 74.7%, sensitivity of 74% was established.

Conclusion. We found a significant relationship between the disturbances of carbohydrate-lipid metabolism and liver fibrosis, the level of galectin-3 and fibrosis stage of the liver. The prognostic value of increasing the level of galectin-3 for predicting the cirrhotic stage of liver fibrosis is substantiated.

About the authors

V. A. Kovalevа

Pavlov First Saint Petersburg State Medical University

Author for correspondence.
Email: infection@spmu.rssi.ru
ORCID iD: 0000-0002-4195-8368

ассистент каф. инфекционных болезней и эпидемиологии

Russian Federation, Saint Petersburg

N. S. Zhevnerova

Pavlov First Saint Petersburg State Medical University

Email: infection@spmu.rssi.ru
ORCID iD: 0000-0001-7231-8980

к.м.н., доц. каф. инфекционных болезней и эпидемиологии

Russian Federation, Saint Petersburg

T. V. Antonova

Pavlov First Saint Petersburg State Medical University

Email: infection@spmu.rssi.ru
ORCID iD: 0000-0002-1784-6235

д.м.н., проф., проф. каф. инфекционных болезней и эпидемиологии

Russian Federation, Saint Petersburg

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Supplementary files

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1. JATS XML
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2. Рис. 1. Частота выявления признаков нарушения углеводно- липидного обмена у больных ХГС на разных стадиях ФП.

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3. Рис. 2. Средний уровень галектина-3 в крови (нг/мл) больных ХГС с разными стадиями ФП.

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4. Рис. 3. ROC-кривая зависимости чувствительности и специфичности установления выраженности ФП от уровня галектина-3 (более или менее 4,79 нг/мл).

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5. Рис. 4. ROC-кривая зависимости чувствительности и специфичности установления выраженности ФП (F4) от уровня галектина-3 в крови (более 5,21 нг/мл).

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