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慢性乙型肝炎患者的肝脂肪变性与代谢因素的关联大于病毒因素。

Hepatic steatosis in chronic hepatitis B patients is associated with metabolic factors more than viral factors.

作者信息

Peng Dandan, Han Ying, Ding Huiguo, Wei Lai

机构信息

Hepatology Institute, Peking University, China.

出版信息

J Gastroenterol Hepatol. 2008 Jul;23(7 Pt 1):1082-8. doi: 10.1111/j.1440-1746.2008.05478.x.

Abstract

BACKGROUND AND AIMS

Hepatic steatosis is commonly seen in chronic hepatitis C (CHC) patients. It has been reported to be associated with both metabolic factors and viral factors, and affects the severity of fibrosis in CHC. However, the relationship between hepatic steatosis and chronic hepatitis B (CHB) is unclear. The aims of this study were to investigate the frequency of hepatic steatosis in CHB patients, to identify the factors associated with its presence, and assess the relationship between the stage of steatosis and the severity of fibrosis.

METHODS

Medical records of 153 adult patients with CHB who had undergone a liver biopsy within the past 4 years were included in the study.

RESULTS

Body mass index (BMI) and age of CHB patients with steatosis was significantly higher than the patients without steatosis (P < 0.05), as determined by the univariate analysis. Steatosis was found to correlate with the BMI values and alanine aminotransferase (ALT) levels, and ALT levels were associated with hepatitis B virus (HBV)-DNA levels and histology activity index (HAI) scores, stages of fibrosis were associated with the HAI score and HBV-DNA, as determined by the multivariate analysis. In contrast, there was no significant association between advanced stages of fibrosis and steatosis.

CONCLUSION

Our data indicate that hepatic steatosis is more frequently present in CHB patients than in the general population. We hypothesize that steatosis in CHB patients may be due to metabolic factors and the ability of HBV to indirectly facilitate the development of steatosis. In the present study, steatosis in CHB patients was not found to be associated with the severity of fibrosis.

摘要

背景与目的

肝脂肪变性在慢性丙型肝炎(CHC)患者中很常见。据报道,它与代谢因素和病毒因素均有关,并影响CHC患者的纤维化严重程度。然而,肝脂肪变性与慢性乙型肝炎(CHB)之间的关系尚不清楚。本研究的目的是调查CHB患者肝脂肪变性的发生率,确定与其存在相关的因素,并评估脂肪变性阶段与纤维化严重程度之间的关系。

方法

本研究纳入了153例在过去4年内接受过肝活检的成年CHB患者的病历。

结果

单因素分析显示,有脂肪变性的CHB患者的体重指数(BMI)和年龄显著高于无脂肪变性的患者(P<0.05)。多因素分析显示,脂肪变性与BMI值和丙氨酸转氨酶(ALT)水平相关,ALT水平与乙型肝炎病毒(HBV)-DNA水平和组织学活动指数(HAI)评分相关,纤维化阶段与HAI评分和HBV-DNA相关。相比之下,纤维化晚期与脂肪变性之间无显著关联。

结论

我们的数据表明,CHB患者中肝脂肪变性的发生率高于普通人群。我们推测,CHB患者的脂肪变性可能是由于代谢因素以及HBV间接促进脂肪变性发展的能力所致。在本研究中,未发现CHB患者的脂肪变性与纤维化严重程度相关。

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