Lesmana Laurentius A, Lesmana C Rinaldi, Pakasi Levina S, Krisnuhoni Ening
Department of Internal Medicine, University of Indonesia, Indonesia.
Acta Med Indones. 2012 Jan;44(1):35-9.
to know the prevalence of liver steatosis in chronic hepatitis B (CHB) patients and evaluate whether its presence was associated with a more progressive disease.
a cross-sectional study was conducted in Cipto Mangunkusumo and Medistra Hospitals, Jakarta on CHB patients between 2007 and 2009. Data on patients' demography, anthropometry, liver function test and hepatitis B serology were collected. Hepatic steatosis was assessed by liver biopsy and graded as mild (<33%), moderate (33-66%) or severe (>66%). Fibrosis stage and necroinflammatory activity were assessed according to the METAVIR system.
one-hundred and seventy four patients were enrolled; 99 (56.9%) among them were men. Patients' mean age was 39.9 ± 10.69 years. About 56% of cases were HBeAg negative. The prevalence of liver steatosis was 29.9%. Patients with liver steatosis had significantly higher body mass index (25.1 ± 3.3 vs. 22.7 ± 3.33 kg/m2, p<0.001) and waist circumference (88.3 vs. 79.0 cm; p<0.001). No association between liver steatosis and HBeAg status (p=0.736). There were no differences of log HBV-DNA levels (5.72 ± 1.993 vs. 6.07 ± 2.077; p=0.675) and liver stiffness (8.3 ± 6.28 vs. 9.5 ± 10.18 kPa) between patients with and without liver steatosis. The presence of significant fibrosis (61.5% vs. 69.7%; p=0.295) and necroinflammation (63.5% vs. 65.6%; p=0.789) was not differed between patients with and without liver steatosis.
liver steatosis was found in 30% of chronic hepatitis B patients. Its presence was mostly associated with central obesity. Unlike chronic hepatitis C, liver steatosis in chronic hepatitis B was not related to a more progressive disease.
了解慢性乙型肝炎（CHB）患者肝脂肪变性的患病率，并评估其是否与疾病进展更相关。
2007年至2009年在雅加达的西托·曼古库苏莫医院和梅迪斯特拉医院对CHB患者进行了一项横断面研究。收集了患者的人口统计学、人体测量学、肝功能检查和乙肝血清学数据。通过肝活检评估肝脂肪变性，并分为轻度（<33%）、中度（33 - 66%）或重度（>66%）。根据METAVIR系统评估纤维化阶段和坏死性炎症活动。
共纳入174例患者；其中99例（56.9%）为男性。患者的平均年龄为39.9±10.69岁。约56%的病例HBeAg阴性。肝脂肪变性的患病率为29.9%。肝脂肪变性患者的体重指数显著更高（25.1±3.3 vs. 22.7±3.33kg/m²，p<0.001）和腰围更大（88.3 vs. 79.0cm；p<0.001）。肝脂肪变性与HBeAg状态之间无关联（p = 0.736）。有和没有肝脂肪变性的患者之间，log HBV - DNA水平（5.72±1.993 vs. 6.07±2.077；p = 0.675）和肝脏硬度（8.3±6.28 vs. 9.5±10.18kPa）没有差异。有和没有肝脂肪变性的患者之间，显著纤维化（61.5% vs. 69.7%；p = 0.295）和坏死性炎症（63.5% vs. 65.6%；p = 0.789）的存在没有差异。
30%的慢性乙型肝炎患者存在肝脂肪变性。其存在主要与中心性肥胖相关。与慢性丙型肝炎不同，慢性乙型肝炎中的肝脂肪变性与疾病进展更无关。
