Abstract:
Objective To investigate mechanism of hypoglycemia in patients with severe chronic hepatitis B, we detected the level of fasting blood serum C-peptide, the level of fasting serum cortisol and the substrate oxidation of the resting energy metabolism in patients with severe chronic hepatitis B.Methods We detected the level of fasting blood serum insulin-like growth factor (IGF-1) , the level of fasting serum insulin, the level of fasting serum C-peptide, the level of fasting serum cortisol in 20 patients with severe chronic hepatitis B and 20 patients with chronic hepatitis B by RIA;resting energy metabolistic indexes (Oxindation of carbohydrate, fat and protein) in patients with severe chronic hepatitis B and patients with chronic hepatitis B by indirect calorimetry.Results The level of fasting blood serum IGF-1 in patients with Severe Chronic Hepatitis B (11.9±2.6) ng/ml were all significantly lower than those in patients with chronic hepatitis B (159.8±35.7) ng/ml (P=0.000) ;the level of serum insulin with severe chronic hepatitis B (19.2±10.9) μ IU/ml was significantly higher than those in the patients with chronic hepatitis B (10.6±7.3) μIU/ml (P=0.034) ;The oxidation of carbohydrate in patients with severe chronic hepatitis B was 38.5%, which was significantly lower than that in patients with chronic hepatitis B 56.9% (P=0.020) ;The oxidation of fat in patients with severe chronic hepatitis B was 38.8%, which was significantly higher than that in patients with chronic hepatitis B 20.1% (P=0.028) .The oxidation of carbohydrate in patients with severe chronic hepatitis B had positive correlation with the level of the fasting blood glucose (r=0.45 P<0.05) .Conclusion The occurrence of hypoglycemia has closely correlation with the level of IGF-1 and insulin, while the level of the fasting blood glucose also has positive correlation with the oxidation of carbohydrate in patients with severe chronic hepatitis B.