关键词: 2型糖尿病, 乙型肝炎, 胰岛素抵抗

Abstract: Objective To study the clinical feature of type 2 diabetes(T2D) patients who were hepatitis B virus(HBV) asymptomatic carriers(HBAC). Methods We collected data from 71 T2D patients with normal liver function(control group) and 50 T2D patients with HBAC(infected group), and compared the clinical data. Results The infected group consists of 32 males and 18 females. Their average age was(56.33±11.54) years. The control group consisted of 40 males and 31 females. Their average age was(55.86±11.56) years. There was no statistically significant difference between the control group and the HBV-infected group in terms of their courses of T2D, prevalence of fatty liver disease(FLD), family history of the diabetes, body mass index(BMI) and waist/hip ratio(WHR). The alanine aminotransferase(ALT) of the HBV-infected group〔(20.69±7.78)U/L〕 and aspartate aminotransferase(AST) of the HBV-infected group〔(25.11±7.48)U/L〕 were significantly higher than those of the control group(P<0.05). The fasting plasma glucose〔FPG,(7.07±2.16)mmol/L〕 and HbA1c (8.62±2.44 %) of the HBV-infected group were significantly lower than those of the control group(8.70±2.84 and 9.66±2.74%, respectively). The postprandial blood glucose(PBG) of the HBV-infected group〔(11.28±1.96)mmol/L〕 and the control group〔(10.54±2.13)mmol/L〕 had no significant difference. The blood glucose fluctuation(PBG/FPG) of the HBV-infected group(1.61±0.59) was significantly higher than that of control group(1.41±0.39). The release of C-peptide in the HBV-infected group and control group had no significant difference. Conclusion Liver function of patients with HBAC and T2D may be impaired. Synthesis, decomposition and gluconeogenesis of hepatic glycogen might be damaged, which may lead to a low FPG but high PBG and significant blood glucose fluctuation. The hepatitis B virus may not obviously impair release of insulin.

Key words: type 2 diabetes, hepatitis B, insulin resistance