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RISS 인기검색어
- 검색키워드
- 저자 : ( Rakesh Pokhrel ) (검색결과 2 건)
- 무료
- 기관 내 무료
- 유료
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Hidden Risk of Liver Disease in Type 2 Diabetes Population
( Sushant Pokhrel ),( Naresh Pokhrel ),( Bashu Dev Pardhe ),( Anit Lamichhane ),( Rakesh Pokhrel ),( Mahendra Prasad Bhatt ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: This study aimed to find the association of liver biomarker with diabetes population. Also, this study focused to find out the risk factors associated with liver disease in Nepalese diabetes patient. Methods: This study was carried out among 238 diabetes and 238 apparently healthy population who attended Modern diagnostic laboratory and Research center, Kathmandu, Nepal. HbA1c and fasting plasma glucose was measure to assess the diabetes population and glycemic control. Aspartate to platelet ratio index (APRI), gamma-glutamyl transpeptidase to platelet ratio (GPR), fibrosis-4 index (FIB-4), and triglyceride and glucose index (TyG) were assess for prediction of hidden risk liver disease. Diabetic patient with higher than the cut-off value obtained from ROC curve analysis of different liver marker index were subjected to multivariate regression analysis to measure the independent risk factor for progression liver disease in different model. Results: Patient with poor glycemic control had a significantly higher level of APRI (P=0.05), GPR (P=0.039), and TyG (P<0.001). Higher HbA1c showed significantly positive correlation with APRI (r=0.154, P=0.017), GPR (r=0.203, P=0.002), FIB4 (r=0.132, P=0.042), and TyG (r=0.510, P<0.001) in diabetic population. The Area under ROC curve of GPR was 0.700 (0.654-0.747), APRI 0.839 (0.803-0.874), FIB-4 0.820 (0.783-0.857), and TyG 0.909 (0.882-0.874) with p-value <0.05. The cut-off value (sensitivity, specificity) of GPR was 0.227 (63.4%, 63%), APRI 0.241 (71.0%, 80.3%), FIB-4 1.65 (71.8%, 77.3%), and TyG 8.85 (79%, 93.3%) respectively. Triglyceride, AST, and GGT was independent risk factor followed same trend in different 4 model while HbA1c and ALT showed independent risk factor in 3 models. Conclusions: APRI, GPR, FIB4 and TyG can define the hidden risk liver disease in T2DM. The independent risk factors for progression of liver disease in those population are hypertriglyceridemia, higher AST, and higher GGT. Routinely screening for markers may prevent progression of liver disease in T2DM patients.
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Status of Vitamin D in Patients with Hepatitis B Infection
( Shantos Subedee ),( Rakesh Pokhrel ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Hepatitis B virus is the most common cause of viral infection that attacks the liver and causes both acute and chronic liver disease. Recent studies have shown some relation between vitamin D and chronic HBV infection, with the level of vitamin D being lower in chronic HBV infected patients as compared to those of normal individual.Our aim was to assess the vitamin D levels in individuals with chronic HBV infection and to compare this with that of normal individuals. Similarly our next aim was to correlate vitamin D levels with the duration of infection. Methods: This cross-sectional study was conducted in Singapore- Gurkha Hospital, Kathmandu Nepal. 100 confirmed chronic HBV infected patients and 100 age sex matched controls were enrolled during the period of January 2016 to september 2016 (9 months). A written consent was taken from those who were willing to be a part of study. Chronic infection was ruled out by taking history of patient and tracing retrospective test result by attending physician. Fasting venous blood was collected to measure vitamin D level. Vitamin D was assessed in biochemistry laboratory by ECLIA method. HBsAG positivity was reconfirmed by ELISA method. Results: The level of vitamin D in patient with Hepatitis B virus (HBV) infection was found to be significantly lower than that in normal/control individual. The mean level of vitamin ‘D’ in case group was 15.50 ± 7.1ng/ml while it was 28.7 ± 7.5 ng/ml in control group. The result was found to be statistically significant with p value<0.001 Likewise the level of vitamin D was found to vary with duration of infection; with infection of more than one year, the level being lower as compared to those with below one year. The mean level of vitamin ‘D’ was 11.3 ± 2.9 and 18.5 ± 7.1 ng/ml in subjects with history of infection of more than one year and below one year respectively. The results were tested with standard t- test and was found to be statistically significant with p value of <0.01. Conclusions: Hepatitis B Virus infection is associated with decreased vitamin D level. The level of serum vitamin D varies with the duration of infection, the level being lower with increase in duration of infection. Since, Individuals with HBV infection are associated with low vitamin D level, the screening of those patients for vitamin D is recommended. Further, continuation of this study with prospective cohort design is recommended to determine the absolute relation of vitamin D and HBV infection.
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