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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 李蘭(Lee-Lan Yen),黃國晉(Kuo-Chin Huang) | |
| dc.contributor.author | Chien-Hsieh Chiang | en |
| dc.contributor.author | 江建勰 | zh_TW |
| dc.date.accessioned | 2021-06-15T04:09:08Z | - |
| dc.date.available | 2010-03-12 | |
| dc.date.copyright | 2010-03-12 | |
| dc.date.issued | 2010 | |
| dc.date.submitted | 2010-02-03 | |
| dc.identifier.citation | 1. Ni YH, Huang LM, Chang MH, et al. Two decades of universal hepatitis B vaccination in Taiwan: Impact and implication for future strategies. Gastroenterology 2007;132:1287-93.
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JAMA 2006;295:1288-99. 46. Ding EL, Song Y, Manson JE, et al. Sex hormone-binding globulin and risk of type 2 diabetes in women and men. N Engl J Med 2009;361:1152-63. 47. Wang SH, Yeh SH, Lin WH, Wang HY, Chen DS, Chen PJ. Identification of androgen response elements in the enhancer I of hepatitis B virus: A mechanism for sex disparity in chronic hepatitis B. Hepatology 2009;50:1392-402. 48. Wang LY, You SL, Lu SN, et al. Risk of hepatocellular carcinoma and habits of alcohol drinking, betel quid chewing and cigarette smoking: A cohort of 2,416 HBsAg-seropositive and 9,421 HBsAg-seronegative male residents in Taiwan. Cancer Causes Control 2003;14:241-50. 49. Wen CP, Tsai SP, Chen CJ, Cheng TY. The mortality risks of smokers in Taiwan: Part I: cause-specific mortality. Prev Med 2004;39:528-35. 50. Besaratinia A, Pfeifer GP. Second-hand smoke and human lung cancer. Lancet Oncol 2008;9:657-66. 51. Chu CM, Hung SJ, Lin J, Tai DI, Liaw YF. 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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/45213 | - |
| dc.description.abstract | 目的：B型肝炎病毒基因量為不良肝病預後的重要決定因子，本研究針對慢性B型肝炎病毒感染者，探討代謝及生活型態因子與其B型肝炎病毒基因量的關係。
方法：本研究自北台灣某大學校園招募141名B型肝炎病毒表面抗原陽性，但不帶有C型肝炎病毒抗體，且未被診斷過肝硬化的B型肝炎病毒帶原者。每名研究樣本需完成自填式問卷、身體測量，並接受血液採集以檢驗B型肝炎病毒血清基因量及代謝因子。所有資料經整理建檔後進行統計分析，最後使用複羅吉斯迴歸分析，找出與有高B型肝炎病毒血清基因量（≥10000 copies/mL）有顯著關係之危險因子。 結果：在調整了相關因子包括年齡、性別、B型肝炎病毒e抗原血清型、高血清丙胺酸轉胺脢及胰島素阻抗性之影響後，肥胖者（身體質量指數≥25 kg/m2）及體重正常者（身體質量指數為18.5－22.9 kg/m2），相對於體重過重者（身體質量指數為23－24.9 kg/m2），皆有高B型肝炎病毒血清基因量的風險；相對危險性分別為3.84和5.27。即使限制在e抗原血清型陰性的B型肝炎病毒帶原者，此現象依然存在。此外，在控制了年齡、性別、B型肝炎病毒e抗原血清型、及高血清丙胺酸轉胺脢之影響後，同時有胰島素阻抗與肥胖兩項危險因子者，會大幅增加有高B型肝炎病毒血清基因量的風險（相對危險性=9.22）。 結論：本研究發現，身體質量指數與B型肝炎病毒血清基因量之間有V型關係，亦即相對於體型正常者或肥胖者，體重過重者反而有較低的B型肝炎病毒血清基因量。此結果顯示，藉由代謝因子來修飾B型肝炎病毒血清基因量的潛在可能性。但是，生活型態因子與B型肝炎血清基因量之間，本研究並未發現有顯著關係存在。 | zh_TW |
| dc.description.abstract | OBJECTIVES: This study aimed to investigate whether metabolic and lifestyle factors were independently associated with serum levels of deoxyribonucleic acid of hepatitis B virus (HBV DNA), a valuable predictor for advanced liver diseases.
METHODS: Participants were hepatitis B virus (HBV) carriers in a university of Northern Taiwan. A total of 141 participants who had positive serum hepatitis B surface antigen, negative serum antibody to hepatitis C virus, and no liver cirrhosis received a structured questionnaire and underwent the anthropometric indices, serum HBV DNA levels and metabolic factors measurements. The odds ratios (ORs) and 95% confidence interval (CI) of high serum HBV DNA level (≥10000 copies/mL) were estimated by multiple logistic regression analyses. RESULTS: As compared to overweight (body mass index (BMI) 23-24.9 kg/m2), obesity (BMI ≥25 kg/m2) (OR=3.84, 95% CI=1.38-10.7, P=0.010) and normal weight (BMI 18.5-22.9 kg/m2) (OR=5.27, 95% CI=1.49-18.6, P=0.010) were at significant risk of high serum HBV DNA levels after adjustment for age, gender, hepatitis B e antigen (HBeAg) serostatus, high alanine aminotransferase (ALT) level, and insulin resistance defined as the homeostasis model assessment of insulin resistance ≥2.5. This effect kept consistent even in stepwise analysis restricted to HBeAg seronegatives. Furthermore, insulin resistance and obesity had additive effects on high HBV DNA levels (OR=9.22, 95% CI=1.73-49.1, P=0.009) after controlling for age, gender, HBeAg serostatus, and high ALT level. CONCLUSIONS: The V shape association that linking overweight with low HBV DNA levels suggests the potential modifiability of hepatitis B viral loads through metabolic factors. Further investigation is warranted for the causal temporality and early preventive strategies. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-15T04:09:08Z (GMT). No. of bitstreams: 1 ntu-99-R97847011-1.pdf: 624909 bytes, checksum: dff453f3f181547dac8fc6132d2faf50 (MD5) Previous issue date: 2010 | en |
| dc.description.tableofcontents | 論文口試委員審定書 I
謝辭 II ABSTRACT IV CONTENTS V LIST OF FIGURES & TABLES VII LIST OF ABBREVIATIONS VIII CHAPTER 1 Introduction 1 1.1 Practicum Unit Features and Brief Introduction 1 1.2 Research Purpose and Research Problems 2 CHAPTER 2 Study Framework & Hypotheses 5 CHAPTER 3 Literature Review 6 3.1 The Known Risk Factors of HBV DNA Levels 7 3.2 The Role of HBV DNA Levels on Subsequent Risk of Cirrhosis or HCC 7 3.3 The Role of Metabolic Factors on Subsequent Risk of Cirrhosis or HCC 10 3.4 The Association between Serum Levels of HBV DNA and TG 14 CHAPTER 4 Methods 15 4.1 Participants 15 4.2 Questionnaire 16 4.3 Anthropometric Indices and Laboratory Measurements 17 4.4 Statistical Analyses 19 CHAPTER 5 Results 21 5.1 Clinical Characteristics of Participants 21 5.2 The Association between Lifestyle Factors and HBV DNA Levels 23 5.3 The Association between Metabolic Factors and High HBV DNA Levels 23 CHAPTER 6 Discussion 28 CHAPTER 7 Resources & Feedback 33 REFERENCES 34 APPENDIX 39 A Detailed Items in the Questionnaire 39 B Ethical Approval 45 C Informed Consent 46 | |
| dc.language.iso | en | |
| dc.subject | 代謝因子 | zh_TW |
| dc.subject | 生活型態 | zh_TW |
| dc.subject | 身體質量指數 | zh_TW |
| dc.subject | 胰島素阻抗 | zh_TW |
| dc.subject | B型肝炎病毒基因 | zh_TW |
| dc.subject | Hepatitis B virus DNA | en |
| dc.subject | passive smoking | en |
| dc.subject | lifestyle factor | en |
| dc.subject | insulin resistance | en |
| dc.subject | obesity | en |
| dc.subject | body mass index | en |
| dc.subject | metabolic factor | en |
| dc.title | 代謝因子在慢性B型肝炎病毒感染中與B型肝炎病毒基因量之關係 | zh_TW |
| dc.title | The Relationship between Metabolic Factors and Hepatitis B Virus DNA Levels in Chronic Hepatitis B Virus Infection | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 98-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 陳為堅 | |
| dc.subject.keyword | B型肝炎病毒基因,代謝因子,身體質量指數,胰島素阻抗,生活型態, | zh_TW |
| dc.subject.keyword | Hepatitis B virus DNA,metabolic factor,body mass index,obesity,insulin resistance,lifestyle factor,passive smoking, | en |
| dc.relation.page | 49 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2010-02-03 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 公共衛生碩士學位學程 | zh_TW |
| 顯示於系所單位： | 公共衛生碩士學位學程 | |
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