Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Laboratory Centre, Xiamen University Malaysia, Sepang, Malaysia.
Scand J Clin Lab Invest. 2021 Apr;81(2):147-159. doi: 10.1080/00365513.2021.1876245. Epub 2021 Feb 2.
The pathogenesis involving non-alcoholic fatty liver disease (NAFLD) in the context of chronic HBV (CHB) virus infection requires to be understood for developing improved modalities of diagnosis and treatment. We retrospectively investigated the association between NAFLD and CHB virus infection in the context of liver fibrosis. Among the 522 consecutive CHB patients who underwent transient elastography between years 2013 and 2016, we studied 455 subjects in the current investigation. Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) scores were generally higher in patients with steatosis and fibrosis or cirrhosis. Antiviral treatment had significantly reduced the hepatitis B virus (HBV) viral load. Other liver function markers showed a significant positive correlation with both CAP and LSM scores. Plasma IL-13 was independently associated with increased CAP score where every increase of 1 unit of IL-13 was associated with an increase in CAP score by 0.98 unit. CCL11 was independently associated with LSM with every increase of CCL11 by a unit that, in turn, was associated with an increase of LSM score. We found that there was a high concurrence of NAFLD among patients with CHB virus infection. The presence of metabolic syndrome and chronic inflammation in CHB virus-infected patients were two independent factors that led to the progression of liver cirrhosis, with IL-13 playing the key role in linking the metabolic with the inflammatory components.
非酒精性脂肪性肝病(NAFLD)在慢性乙型肝炎病毒(CHB)感染背景下的发病机制需要加以理解,以便开发出更好的诊断和治疗方法。我们回顾性地研究了在肝纤维化背景下,NAFLD 与 CHB 病毒感染之间的关联。在 2013 年至 2016 年间接受瞬时弹性成像的 522 例连续 CHB 患者中,我们目前的研究调查了 455 例患者。在存在脂肪变性和纤维化或肝硬化的患者中,受控衰减参数(CAP)和肝硬度测量(LSM)评分通常较高。抗病毒治疗显著降低了乙型肝炎病毒(HBV)病毒载量。其他肝功能标志物与 CAP 和 LSM 评分均呈显著正相关。血浆白介素-13(IL-13)与 CAP 评分的增加独立相关,IL-13 每增加 1 单位,CAP 评分增加 0.98 单位。趋化因子配体 11(CCL11)与 LSM 独立相关,CCL11 每增加 1 单位,LSM 评分相应增加。我们发现,在 CHB 病毒感染患者中,NAFLD 的发生率很高。代谢综合征和慢性炎症的存在是导致 CHB 病毒感染患者肝硬化进展的两个独立因素,IL-13 在将代谢与炎症成分联系起来方面起着关键作用。