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Dynamic immune response and its influencing factors in COVID-19 patients with non-alcoholic fatty liver disease:A cohort study 认领 引用 被引量：1
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作者 Pan Yan Rui Li +4 位作者 Xiao-Yan Yuan Yong Wang Li-Juan Lan Xiao-Ping Yu Da-Feng Liu 《World Journal of Hepatology》 2026年第2期101-125,共25页
BACKGROUND Dynamic alterations in lymphocyte subsets demonstrate significant correlations with clinical disease severity in patients with coronavirus disease 2019(COVID-19).As the most prevalent chronic liver disease ... BACKGROUND Dynamic alterations in lymphocyte subsets demonstrate significant correlations with clinical disease severity in patients with coronavirus disease 2019(COVID-19).As the most prevalent chronic liver disease globally,non-alcoholic fatty liver disease(NAFLD)exhibits distinct chronic inflammatory and immunometabolic disturbances that may substantially affect immune response patterns in COVID-19 patients.Nevertheless,the characteristics of lymphocyte subset dynamics and their clinical implications in COVID-19-NAFLD remain to be fully elucidated.AIM To characterize the dynamic changes in lymphocyte subsets among COVID-19 patients with NAFLD,in order to delineate their immunological profiles and inform clinical management strategies.METHODS The cohort study compared lymphocyte subpopulations in 858 COVID-19 patients and 670 COVID-19-NAFLD patients at admission,discharge,and 2-week/4-week post-discharge follow-ups.RESULTS Compared to COVID-19 patients without NAFLD,NAFLD-comorbid patients demonstrated persistently elevated CD3+CD4+counts as well as lymphocyte counts and percentages at admission and at the 2-week and 4-week follow-ups post-discharge(all P<0.05).Among COVID-19-NAFLD patients,those aged≥60 years had significantly lower CD3+counts,CD3+CD4+counts,CD3+CD8+counts,lymphocyte counts and percentages,and CD19+counts and percentages at all assessed time points(all P<0.05);significant liver fibrosis correlated with reduced CD3+CD4+counts,CD3+CD8+counts,and lymphocyte counts and percentages across all time points(all P<0.05);multimorbidity(≥3 comorbidities)exacerbated immune imbalance,marked by elevated CD3+CD4+percentages and CD56+counts at admission,increased CD3+CD4+counts,lymphocyte counts,and CD19+counts and percentages at discharge,as well as sustained increases in CD3+CD4+counts at the 2-week follow-up and higher CD3+CD4+percentages at the 4-week post-discharge follow-up(all P<0.05);and obesity and elevated liver enzymes were independently linked to higher CD3+CD4+counts,CD19+counts,and lymphocyte counts at all post-admission evaluations(from discharge through the 4-week follow-up)(all P<0.05).CONCLUSION Age,liver fibrosis,comorbidities,obesity,liver enzyme abnormalities,vaccination status,low-density lipoprotein cholesterol,and hemoglobin A1c significantly modulate immune responses in COVID-19-NAFLD patients,warranting targeted clinical attention.Furthermore,patients with uncomplicated NAFLD(including lean NAFLD)also require particular clinical attention to mitigate risks of immune imbalance. 展开更多
关键词 COVID-19 Non-alcoholic fatty liver disease Lymphocyte subsets Dynamic immune response Risk factors
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Diagnostic efficacy and influencing factors of non-invasive liver fibrosis scores in chronic hepatitis B fibrosis:Cross-sectional study 认领 引用
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作者 Chun-Xia Wang Pan Yan +4 位作者 Li-Juan Lan Ben-Nan Zhao Jun Kang Mao-Quan Li Da-Feng Liu 《World Journal of Hepatology》 2026年第5期184-200,共17页
BACKGROUND During the pathological advancement of chronic hepatitis B(CHB)toward cirrhosis and hepatocellular carcinoma,liver fibrosis acts as a pivotal transitional phase.Currently,non-invasive diagnostic techniques ... BACKGROUND During the pathological advancement of chronic hepatitis B(CHB)toward cirrhosis and hepatocellular carcinoma,liver fibrosis acts as a pivotal transitional phase.Currently,non-invasive diagnostic techniques have become key substitutes for liver biopsy.However,the diagnostic efficacy of different indicators varies across populations,and the influence of factors such as gender,nutritional status,and liver function reserve remains unclear,necessitating further clarification.AIM To evaluate the diagnostic performance of serological indicators,including the aspartate transaminase to platelet ratio index(APRI),the fibrosis-4 index(FIB-4),the gamma-glutamyl transferase to platelet ratio(GPR),and the aspartate aminotransferase to alanine aminotransferase ratio(AST/ALT),with liver stiffness measurement(LSM)via FibroScan as a reference,and to investigate the influence of gender,nutritional status,and Child-Pugh classification on these serum assessment indicators.METHODS For this cross-sectional investigation,627 CHB cases were consecutively enrolled at Chengdu Public Health Clinical Medical Center during the four-year interval from December 2020 to December 2024.Extensive data collection incorporated FibroScan-derived LSM alongside four well-validated serum fibrosis indices:APRI,FIB-4,GPR,and AST/ALT.Associations between these serum-derived indices and different fibrosis stages were examined;the effects of gender,nutritional status,and Child-Pugh class on the diagnostic performance of these non-invasive scoring tools were also assessed.RESULTS The median age of CHB participants was 47 years,with male patients comprising 69.86%(438/627).Spearman correlation testing revealed that all non-invasive liver fibrosis assessment indices showed robust associations with FibroScan-measured LSM values and FibroScan-derived liver fibrosis staging(P<0.001);notably,the correlation between GPR and both LSM values and fibrosis staging was the most pronounced(r=0.609).Univariate statistical analyses revealed significant disparities across the nutritional risk subgroup,the Child-Pugh staging subgroup,and each of the assessed indices(P<0.001).Meanwhile,multivariable regression modeling showed that the GPR exhibited the most favorable diagnostic efficacy for two fibrosis categories:“Any fibrosis(F1-F4)”and“significant fibrosis(F3-F4)”.For the GPR model,the area under the curve(AUC)values were 0.816[95%confidence interval(CI):0.779-0.853]and 0.871(95%CI:0.844-0.899),with both outcomes corresponding to P values<0.001.Analysis of receiver operating characteristic curves demonstrated that the GPR exhibited strong performance in identifying significant fibrosis:it achieved an AUC of 0.828(95%CI:0.796-0.860),alongside 87.6%sensitivity and 64.4%specificity.Moreover,the FIB-4 index demonstrated robust diagnostic performance(AUC=0.814),surpassing that of both APRI and the AST/ALT ratio.CONCLUSION GPR and FIB-4 function as valid serological assessment indicators for identifying liver fibrosis in patients with CHB,especially in instances of advanced fibrosis and cirrhotic stages.In clinical settings,a holistic evaluation of liver fibrosis is recommended by incorporating the patient’s gender,nutritional status,and liver functional reserve to enhance diagnostic precision. 展开更多
关键词 Chronic hepatitis B Gamma-glutamyl transferase to platelet ratio Fibrosis-4 index Aspartate aminotransferase to platelet ratio index Aspartate transaminase to alanine aminotransferase ratio Child-Pugh classification Nutritional risk
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Chronic hepatitis B with type 2 diabetes mellitus: Association between glycemic control and liver fibrosis 认领 引用
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作者 Yan Luo Rui Li +6 位作者 Jun Kang Ben-Nan Zhao Li-Juan Lan Feng-Jiao Gao Xiao-Xia Ren Yan-Feng Zhu Da-Feng Liu 《World Journal of Diabetes》 SCIE 2025年第7期227-243,共17页
BACKGROUND The interplay between abnormal glucose metabolism and the progression of liver fibrosis in patients with both chronic hepatitis B(CHB)and type 2 diabetes mellitus(T2DM)remains unclear.Previous studies have ... BACKGROUND The interplay between abnormal glucose metabolism and the progression of liver fibrosis in patients with both chronic hepatitis B(CHB)and type 2 diabetes mellitus(T2DM)remains unclear.Previous studies have suggested that the coexistence of these conditions may exacerbate liver inflammation and fibrosis;however,the impacts of dynamic changes in glucose metabolism indicators,hypoglycemic medication regimens,and glycemic control status on liver fibrosis require further elucidation.AIM To explore the effect of glycemic control on hepatic fibrosis in patients with CHB and T2DM.METHODS A total of 420 patients with CHB and T2DM admitted to the Public Health Clinical Center of Chengdu between October 2018 and January 2022 were retrospectively included and classified according to liver stiffness measurement and glycemic control for between-group comparisons.RESULTS Significant differences were observed in the alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase,AST/ALT ratio,total bilirubin,direct bilirubin,diabetes treatment program,and thrombin time values among the liver fibrosis groups(adjusted P<0.05).Significant differences in albumin and gamma-glutamyl transferase levels were observed among the groups categorized by glucose status at admission(adjusted P<0.05).A positive correlation between fasting plasma glucose(FPG)and liver stiffness measurement was found to be mediated by ALT and AST.Fibrinogen and the international normalized ratio were positively correlated with glycated hemoglobin A1c,while the fibrosis-4 score,ALT,AST/ALT ratio,type III procollagen N-terminal peptide,ferritin,and activated partial thromboplastin time were correlated with FPG at admission.Additionally,AST was positively correlated with FPG at discharge(P<0.05).CONCLUSION Specific glucose metabolic parameters,hypoglycemic agents,and glycemic control status markers are associated with hepatic fibrosis in patients with both CHB and T2DM.Close blood glucose monitoring,optimized use of hypoglycemic agents,and continuous maintenance of good glycemic control may slow the progression of liver fibrosis in patients with CHB and T2DM. 展开更多
关键词 Chronic hepatitis B Type 2 diabetes mellitus Liver fibrosis Hypoglycemic agents Glycemic control status
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Glucose metabolism continuous deteriorating in male patients with human immunodeficiency virus accepted antiretroviral therapy for 156 weeks 认领 引用 被引量：1
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作者 Da-Feng Liu Xin-Yi Zhang +5 位作者 Rui-Feng Zhou Lin Cai Dong-Mei Yan Li-Juan Lan Sheng-Hua He Hong Tang 《World Journal of Diabetes》 SCIE 2023年第3期299-312,共14页
BACKGROUND The dynamic characteristics of glucose metabolism and its risk factors in patients living with human immunodeficiency virus(PLWH)who accepted primary treatment with the efavirenz(EFV)plus lamivudine(3TC)plu... BACKGROUND The dynamic characteristics of glucose metabolism and its risk factors in patients living with human immunodeficiency virus(PLWH)who accepted primary treatment with the efavirenz(EFV)plus lamivudine(3TC)plus tenofovir(TDF)(EFV+3TC+TDF)regimen are unclear and warrant investigation.AIM To study the long-term dynamic characteristics of glucose metabolism and its contributing factors in male PLWH who accepted primary treatment with the EFV+3TC+TDF regimen for 156 wk.METHODS This study was designed using a follow-up design.Sixty-one male treatmentnaive PLWH,including 50 cases with normal glucose tolerance and 11 cases with prediabetes,were treated with the EFV+3TC+TDF regimen for 156 wk.The glucose metabolism dynamic characteristics,the main risk factors and the differences among the three CD4+count groups were analyzed.RESULTS In treatment-naive male PLWH,regardless of whether glucose metabolism disorder was present at baseline,who accepted treatment with the EFV+3TC+TDF regimen for 156 wk,a continuous increase in the fasting plasma glucose(FPG)level,the rate of impaired fasting glucose(IFG)and the glycosylated hemoglobin(HbA1c)level were found.These changes were not due to insulin resistance but rather to significantly reduced isletβcell function,according to the homeostasis model assessment ofβcell function(HOMA-β).Moreover,the lower the baseline CD4+T-cell count was,the higher the FPG level and the lower the HOMA-βvalue.Furthermore,the main risk factors for the FPG levels were the CD3+CD8+cell count and viral load(VL),and the factors contributing to the HOMA-βvalues were the alanine aminotransferase level,VL and CD3+CD8+cell count.CONCLUSION These findings provide guidance to clinicians who are monitoring FPG levels closely and are concerned about IFG and decreased isletβcell function during antiretroviral therapy with the EFV+3TC+TDF regimen for long-term application. 展开更多
关键词 Human immunodeficiency virus Antiretroviral therapy Fasting plasma glucose Dynamic change Long-term
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Clinical characteristics of 290 foreign-imported cases infected with SARS-CoV-2 in Chengdu, China 认领 引用
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作者 Qing Du Ben-Nan Zhao +4 位作者 Li-Juan Lan Ya-Ling Liu Yue-Lian Wang Hong Chen Da-Feng Liu 《Journal of Hainan Medical University》 CAS 2021年第10期8-12,共5页
Objective:To analyze the epidemiological and clinical characteristics of foreign-imported patients infected with SARS-CoV-2 in Chengdu City.Methods:A total of 290 foreign-imported patients infected with SARS-CoV-2 and... Objective:To analyze the epidemiological and clinical characteristics of foreign-imported patients infected with SARS-CoV-2 in Chengdu City.Methods:A total of 290 foreign-imported patients infected with SARS-CoV-2 and discharged from Public Health Clinical Center of Chengdu were included in our study,they were divided into asymptomatic infection group(131 cases)and confirmed cases group(159 cases)in order to compare the epidemiology,clinical characteristics and laboratory tests between two groups.Multi-factor logistic regression analysis was used to investigate the influence factors of becoming a dominant infection after infected with SARS-CoV-2.Results:Among the 290 cases aged from 2 months to 68 years old,83.4%were males,62.1%came from Asia,and 43.8%were complicated with fatty liver disease,the age group of 14-49 years old had the largest number(247 cases).80.5%confirmed case group cases were general type,there was only 1 severe patient.Hospital stays in asymptomatic infection group was shorter than that in confirmed cases group,lymphocyte count,CD4+T count,CD8+T count,CD4+T/CD8+T creatine kinase in two groups half a month after discharge were relatively lower than those on admission,and alanine aminotransferase,aspartate aminotransferase,albumin,lactate dehydrogenase,creatine kinase isoenzyme were relatively higher than those on admission(P<0.05).Logistic regression analysis showed that increased age,decreased lymphocyte count on admission and increased lactate dehydrogenase on admission were associated with dominant infection.Chest CT of 13 general type cases indicated an increase in lesions compared with that at discharge and 3 of them had re-detectable positive RNA test.Conclusion:The majority of foreign-imported cases in Chengdu are mainly from Asia,fewer of them are severe patients.In the early stage of recovery,some SARS-CoV-2 infected patients still have intermittent viral replication.Early isolation and early treatment of imported patients is not only conducive to epidemic prevention and control,but also may change the natural course of the disease. 展开更多
关键词 COVID-19 Asymptomatic infection cases Imported from abroad Clinical characteristics Fatty liver disease
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