Cai Shaohang, Ou Zejin, Liu Duan, Liu Lili, Liu Ying, Wu Xiaolu, Yu Tao, Peng Jie
Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China.
The Third People's Hospital of Nanhai District, Foshan, China.
United European Gastroenterol J. 2018 May;6(4):558-566. doi: 10.1177/2050640617751252. Epub 2018 Jan 16.
We investigated whether metabolic syndrome exacerbated the risk of liver fibrosis among chronic hepatitis B patients and risk factors associated with liver steatosis and fibrosis in chronic hepatitis B patients with components of metabolic syndrome.
This study included 1236 chronic hepatitis B patients with at least one component of metabolic syndrome. The controlled attenuation parameter and liver stiffness, patient information and relevant laboratory data were recorded.
Controlled attenuation parameter was increased progressively with the number of metabolic syndrome components ( < 0.001). Multivariate analysis indicated younger age, high gamma-glutamyltransferase level, high waist-hip ratio, and high body mass index were independent risk factors associated with nonalcoholic fatty liver disease among chronic hepatitis B patients with metabolic syndrome. In the fibrosis and non-fibrosis groups, most of blood lipid was relatively lower in fibrosis group. An increased proportion of chronic hepatitis B patients with liver fibrosis was found concomitant with an increasing number of components of metabolic syndrome. Male gender, older age, smoking, aspartate aminotransferase levels, high body mass index, and low platelet level were identified as independent risk factors associated with liver fibrosis.
For chronic hepatitis B patients with coexisting components of metabolic syndrome, stratification by independent risk factors for nonalcoholic fatty liver disease and fibrosis can help with management of their disease.
我们研究了代谢综合征是否会增加慢性乙型肝炎患者肝纤维化的风险,以及代谢综合征各组分与慢性乙型肝炎患者肝脂肪变性和纤维化相关的危险因素。
本研究纳入了1236例至少有一项代谢综合征组分的慢性乙型肝炎患者。记录受控衰减参数和肝脏硬度、患者信息及相关实验室数据。
受控衰减参数随代谢综合征组分数量的增加而逐渐升高(<0.001)。多变量分析表明,在患有代谢综合征的慢性乙型肝炎患者中,年龄较小、γ-谷氨酰转移酶水平较高、腰臀比高和体重指数高是非酒精性脂肪性肝病的独立危险因素。在纤维化组和非纤维化组中,纤维化组的大多数血脂相对较低。发现肝纤维化的慢性乙型肝炎患者比例随着代谢综合征组分数量的增加而增加。男性、年龄较大、吸烟、天冬氨酸转氨酶水平、高体重指数和低血小板水平被确定为与肝纤维化相关的独立危险因素。
对于并存代谢综合征组分的慢性乙型肝炎患者,通过非酒精性脂肪性肝病和纤维化的独立危险因素进行分层有助于疾病管理。