Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul, 137-701, South Korea.
Department of Biostatistics, College of Medicine, The Catholic University of Korea, 222 Banpodaero, Seochogu, Seoul, 137-701, South Korea.
Hepatol Int. 2016 May;10(3):470-7. doi: 10.1007/s12072-015-9672-7. Epub 2016 Feb 5.
Hepatic osteodystrophy has been reported in patients with various chronic liver diseases, including liver cirrhosis. However, it has not been well investigated in patients with hepatitis B virus infection. The aim of this study was to investigate the association between hepatitis B surface antigen (HBsAg) seropositivity and bone mineral density (BMD) in a population representative of normal Koreans.
Subjects with both HBsAg and BMD levels examined during the 2008-2010 Korea National Health and Nutrition Examination Surveys were included. HBsAg-seropositive (+) subjects were compared with those who were HBsAg-seronegative (-). BMD was measured at the lumbar spine and femur by dual-energy X-ray absorptiometry. Multivariable logistic regression was performed for BMD .
In total, 11,306 participants were included in this study, among which 423 (3.7 %) were HBsAg(+): 153 premenopausal female (3.4 %), 83 postmenopausal female (3.5 %), and 187 male (4.2 %). Multivariable logistic regression analysis adjusted for age and body mass index showed that HBsAg(+) male had significantly lower BMD of the femoral neck than HBsAg(-) male (0.810 ± 0.009 vs. 0.827 ± 0.002 g/cm(2), p = 0.035). Further adjustment for waist circumference, smoking, drinking, exercise, income, occupation, and vitamin D levels showed that HBsAg(+) male had significantly lower BMD of the femur neck (0.810 ± 0.010 vs. 0.831 ± 0.002 g/cm(2), p = 0.032) and lumbar spine (0.953 ± 0.011 vs. 0.974 ± 0.003 g/cm(2), p = 0.049) than HBsAg(-) male.
HBsAg seropositivity was significantly associated with lower BMD in male. Future long-term prospective studies investigating bone turnover markers and hormones are needed to better understand the pathophysiology and clinical significance of chronic hepatitis B virus-related hepatic osteodystrophy.
已有研究报道，在各种慢性肝病患者中，包括肝硬化患者中存在肝性骨营养不良。然而，在乙型肝炎病毒（HBV）感染者中，其骨密度（BMD）尚未得到很好的研究。本研究旨在调查韩国普通人群中乙型肝炎表面抗原（HBsAg）阳性与 BMD 之间的关系。
本研究纳入了在 2008-2010 年韩国国家健康和营养检查调查中同时进行 HBsAg 和 BMD 检测的人群。将 HBsAg 阳性（+）者与 HBsAg 阴性（-）者进行比较。采用双能 X 线吸收法测量腰椎和股骨的 BMD。对 BMD 进行多变量逻辑回归分析。
共纳入 11306 名参与者，其中 423 名（3.7%）为 HBsAg（+）：153 名绝经前女性（3.4%），83 名绝经后女性（3.5%）和 187 名男性（4.2%）。多变量逻辑回归分析调整年龄和体重指数后，HBsAg（+）男性股骨颈 BMD 明显低于 HBsAg（-）男性（0.810±0.009 vs. 0.827±0.002 g/cm²，p=0.035）。进一步调整腰围、吸烟、饮酒、运动、收入、职业和维生素 D 水平后，HBsAg（+）男性股骨颈 BMD 仍明显低于 HBsAg（-）男性（0.810±0.010 vs. 0.831±0.002 g/cm²，p=0.032）和腰椎 BMD（0.953±0.011 vs. 0.974±0.003 g/cm²，p=0.049）。
HBsAg 阳性与男性 BMD 降低显著相关。未来需要进行长期前瞻性研究，以调查骨转换标志物和激素，从而更好地理解慢性乙型肝炎病毒相关肝性骨营养不良的病理生理学和临床意义。
