Poortahmasebi Vahdat, Alavian Seyed Moayed, Keyvani Hossein, Norouzi Mehdi, Mahmoodi Mahmood, Jazayeri Seyed Mohammad
Hepatitis B Molecular Laboratory, Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran E-mail :
Asian Pac J Cancer Prev. 2014;15(9):3879-84. doi: 10.7314/apjcp.2014.15.9.3879.
In chronic hepatitis B (CHB), the presence of hepatic steatosis (HS) seems to be associated with known host and viral factors which may influence the long-term prognosis of chronic hepatitis B (CHB), probably leading to cirrhosis and hepatocellular carcinoma (HCC). Different from chronic hepatitis C (CHC), factors associated with HS in CHB are not clearly explored.
160 CHB patients were divided into two groups depending on the results of liver biopsy. Group I consisted of 71 patients with confirmed steatosis. Group II comprised 89 patients without steatosis. The groups were compared in terms of basal characteristics, body mass index (BMI), liver enzymes (ALT, AST, ALP), serum fasting blood sugar (FBS) and lipids, hepatitis B e antigen (HBeAg), viral load, and histological findings.
In terms of host factors, male gender, older age, BMI, high serum FBS and lipid levels were associated with HS. On the other hand, ALT levels, the HAI scores of necroinflammation and stage of fibrosis did not associate with HS. On multivariate analysis, parameters of sex, BMI, cholesterol and FBS levels were independently associated with HS. Regarding viral factors, HBeAg negativity was significantly associated with HS (81.7%, p value 0.006), but not HBV DNA level (p value 0.520).
HS in CHB appears to be unrelated to the status of HBV replication. However, fibrosis progression in CHB is related to variable host factors. HS may be enhanced through these factors in HBV chronic patients.
在慢性乙型肝炎（CHB）中，肝脂肪变性（HS）的存在似乎与已知的宿主和病毒因素相关，这些因素可能影响慢性乙型肝炎（CHB）的长期预后，可能导致肝硬化和肝细胞癌（HCC）。与慢性丙型肝炎（CHC）不同，CHB中与HS相关的因素尚未得到明确探讨。
根据肝活检结果将160例CHB患者分为两组。第一组由71例确诊为脂肪变性的患者组成。第二组包括89例无脂肪变性的患者。对两组患者的基础特征、体重指数（BMI）、肝酶（ALT、AST、ALP）、血清空腹血糖（FBS）和血脂、乙肝e抗原（HBeAg）、病毒载量及组织学结果进行比较。
在宿主因素方面，男性、年龄较大、BMI、高血清FBS和血脂水平与HS相关。另一方面，ALT水平、坏死炎症的HAI评分和纤维化分期与HS无关。多因素分析显示，性别、BMI、胆固醇和FBS水平参数与HS独立相关。关于病毒因素，HBeAg阴性与HS显著相关（81.7%，p值0.006），但与HBV DNA水平无关（p值0.520）。
CHB中的HS似乎与HBV复制状态无关。然而，CHB中的纤维化进展与多种宿主因素有关。这些因素可能会加重HBV慢性患者的HS。
