Correlation of the levels of angiotensin Ⅱ and angiotensin (1-7) with the degree of chronic hepatitis B liver fibrosis

Objective To investigate the differences in the plasma levels of angiotensin Ⅱ( Ang Ⅱ) and angiotensin( 1-7) [Ang( 1-7) ]in different stages among patients with chronic hepatitis B( CHB) liver fibrosis and their significance in the pathogenesis of liver fibrosis.Methods A prospective study was performed. A total of 86 patients with hepatitis B virus( HBV) infection who attended our hospital from March 2017 to March 2019 were enrolled and divided into CHB group( group A) with 25 patients,compensated hepatitis B cirrhosis group( group B) with 31 patients,and decompensated hepatitis B cirrhosis group( group C) with 30 patients. The double-antibody sandwich method was used to measure the plasma levels of Ang Ⅱ and Ang( 1-7),and FibroTouch scan was used for liver stiffness measurement( LSM). A one-way analysis of variance was used for comparison of continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between groups. A binary linear correlation analysis was used to investigate the correlation of the plasma levels of Ang Ⅱ and Ang( 1-7) with LSM; a Spearman rank correlation analysis was used to investigate the correlation of the plasma levels of Ang Ⅱ and Ang( 1-7) with the progression of CHB liver fibrosis; a logistic regression analysis was used to evaluate the value of Ang Ⅱ,Ang( 1-7),and LSM in predicting hepatitis B cirrhosis. Results With the progression of liver fibrosis from group A to group C,there was a significant increase in course of disease( 5. 2 ± 1. 3 years vs 7. 8 ± 1. 6 years vs 10. 1 ± 1. 5 years,F = 4. 266,P = 0. 002),a significant reduction in the proportion of patients receiving antiviral therapy( 76. 00% vs 64. 52% vs 53. 33%,χ2= 5. 544,P < 0. 001),significant increases in Ang II( 51. 01 ±8. 68 pg/ml vs 74. 38 ± 10. 05 pg/ml vs 102. 78 ± 13. 22 pg/ml,F = 520. 260,P < 0. 001),Ang II/Ang( 1-7) ratio( 1. 06 ± 0. 41 vs2. 32 ± 0. 23 vs 5. 82 ± 1. 24,F = 18. 860,P < 0. 001),and LSM( 6. 85 ± 1. 26 kP a vs 18. 25 ± 3. 22 kP a vs 26. 84 ± 7. 57 kP a,F = 93. 260,P <0. 001),and a significant reduction in Ang( 1-7)( 45. 93 ± 10. 24 pg/ml vs 31. 52 ± 9. 62 pg/ml vs 16. 55 ± 9. 48 pg/ml,F = 209. 860,P <0. 001). Ang II and Ang II/Ang( 1-7) ratio were positively correlated with LSM( r = 0. 623 and 0. 813,both P < 0. 01),while Ang( 1-7) was negatively correlated with LSM( r =-0. 677,P < 0. 01). Ang II,Ang II/Ang( 1-7) ratio,and LSM gradually increased with the progression of liver fibrosis( r = 0. 639,0. 886,and 0. 712,all P < 0. 01),while Ang( 1-7) was negatively correlated with the progression of liver fibrosis( r =-0. 653,P < 0. 01). Ang II/Ang( 1-7) ratio and LSM had an early warning effect for liver cirrhosis in patients with HBV infection( odds ratio = 1. 884 and 2. 015,both P < 0. 01). Conclusion In patients with HBV infection,there are gradual increases in Ang II and Ang II/Ang( 1-7) ratio and a gradual reduction in Ang( 1-7) with the aggravation of liver fibrosis. Dynamic monitoring of the plasma levels of Ang II and Ang( 1-7) can provide a reference for real-time assessment of liver fibrosis and decision-making in clinical diagnosis and treatment.