ارزیابی مقایسه‌ای سطح ادراری آفلاتوکسین M1 در افراد مبتلا به Hepatitis C Virus (HCV) و افراد سالم

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشجوی کارشناسی ارشد، گروه قارچ‌شناسی و انگل‌شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 استادیار، گروه قارچ‌شناسی و انگل‌شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 استادیار، گروه داخلی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران

4 دانشجوی دکتری، گروه مدیریت خدمات بهداشتی و درمانی، دانشگاه آزاد اسلامی، واحد علوم و تحقیقات تهران، تهران، ایران

5 دانشجوی کارشناسی پرستاری، دانشکده‌ی پرستاری، دانشگاه آزاد اسلامی، واحد شهرکرد، شهرکرد، ایران

چکیده

مقدمه: آفلاتوکسین‌ها، متابولیت ثانویه‌ی گونه‌های سکشن فلاوی (Aspergillus section flavi) می‌باشند. آفلاتوکسین B1، (AFB1 یا Aflatoxin B1) هپاتوکارسینوژن، تراتوژن و موتاژن است. آفلاتوکسین M1 (AFM1)، فرم هیدروکسیله شده‌ی AFB1 است. با توجه به اثرات تخریبی کبد در اثر هپاتیت و آفلاتوکسین، این مطالعه با هدف ارزیابی میزان میانگین سطح ادراری AFM1 در دو گروه افراد سالم (گروه شاهد) و مبتلایان به ویروس هپاتیت C (HCV یا Hepatitis C virus) (گروه مورد) انجام گرفت.روش‌ها: از 71 فرد مبتلا به HCV و 71 فرد سالم نمونه‌ی خون و ادرار گرفته شد. نمونه‌ی ادرار به روش Enzyme-linked immunosorbent assay (ELISA) از نظر میزان AFM1 مورد بررسی قرار گرفت. نمونه‌ی خون از نظر آنزیم‌های Serum glutamic-oxaloacetic transaminase (SGOT)، Serum glutamic-pyruvic transaminase (SGPT)، آلکالن فسفاتاز، بیلی‌روبین توتال و بیلی‌روبین دایرکت بررسی شد.یافته‌ها: 57/29 درصد از افراد گروه مورد و 57/19 درصد از افراد گروه شاهد در ادرار خود دارای AFM1 بودند. میانگین AFM1 افراد مبتلا به HCV، معادل 45/2 پیکوگرم بر میلی‌لیتر و میانگین AFM1 موجود در ادرار گروه شاهد 66/1 پیکوگرم بر میلی‌لیتر به دست آمد. نتایج به دست آمده از سطح AFM1 در دو گروه دارای تفاوت معنی‌داری بود (050/0 = P). غلظت سرمی SGPT و آلکالن فسفاتاز در افراد گروه مورد دارای AFM1 بیشتر از افراد فاقد AFM1 بود و این تفاوت غلظت معنی‌دار بود (012/0 = P). غلظت سرمی SGOT، بیلی‌روبین توتال و بیلی‌روبین مستقیم در دو گروه پیش‌گفته تفاوت معنی‌داری نداشت.نتیجه‌گیری: وجود AFB1 در مبتلایان به HCV ممکن است سبب تسریع پیشرفت بیماری مزمن کبدی گردد. از این رو، پیشنهاد می‌گردد با اصلاح الگوی مصرف مواد غذایی، از مصرف آفلاتوکسین‌ها جلوگیری گردد و در نتیجه، از سرعت پیشرفت فرم مزمن بیماری کاسته شود.

کلیدواژه‌ها

عنوان مقاله [English]

Comparative Study of the Urinary Level of Aflatoxin M1 in Patients with Hepatitis C Virus (HCV) and Healthy People

نویسندگان [English]

  • Amin Soltanpour 1
  • Parvin Dehghan 2
  • Mohammad Hadi Shafigh-Ardestani 3
  • Abbasali Asgari 4
  • Sahar Soltanpour 5
1 MSc Student, Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Department of Mycology and Parasitology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Assistant Professor, Department of Internal Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
4 PhD Student, Department of Health Service Management, Science and Research Branch, Islamic Azad University, Tehran, Iran
5 Student, Department of Nursing, School of Nursing, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran
چکیده [English]

B1 (AFB1) is hepatocarcinogen, teratogen and mutagen. Aflatoxin M1 (AFM1) is the hydroxylated metabolite of AFB1. The liver protects the body by lowering the toxicity of AFB1 to form different hydroxylates like AFM1. According to the synergistic effect of hepatitis and also AFB1 as the parent molecule of AFM1, the main purpose of this study was to assess the relationship between the mean levels of AFM1, in the hepatitis-C-virus (HCV)-positive patients compared to healthy individuals.Methods: After the tests of liver function enzymes, the level of AFM1 was measured and compared in the urine sample of 71 patients with HCV and 71 healthy individuals. The AFM1 of urine samples were tested using enzyme-linked immunosorbent assay (ELISA) method. Besides, the levels of serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), alkaline phosphatase, total bilirubin and direct bilirubin were assessed in the blood samples.Findings: The urine of 29.7% of HCV-positive patients and 19.71% of healthy individuals consisted of some amount of AFM1. The mean level of AFM1 was 2.45 and 1.66 pg/ml in patients and controls, respectively; which was significantly different (P = 0.005). The mean levels of SGPT and alkaline phosphatase were significantly more among HCV-positive patients with AFM1 compared to those without AFM1 (P = 0.012). But, there was not any significant difference between the mean levels of SGOT and total and direct bilirubin between the HCV-positive patients with and without AFM1.Conclusion: The mean levels of SGPT and Alkaline phosphatase, which are more exclusive to survey of liver function, were significantly different between HCV-positive patients with and without AFM1. Consequently, progression of the chronic liver disease is caused by the existence of AFB1 in HCV-positive patients; therefore, the reduction of AFM1 via improving the food consumption pattern can prevent this progression.

کلیدواژه‌ها [English]

  • Aflatoxin M1
  • Hepatitis C virus (HCV)
  • Liver dysfunctions

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مجله دانشکده پزشکی اصفهان
دوره 34، شماره 404 - شماره پیاپی 404
آذر و دی 1395
صفحه 1275-1281

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سابقه مقاله

  • تاریخ دریافت: 01 شهریور 1395
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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