Wang Ming-Fang, Wan Bo, Wu Yin-Lian, Huang Jiao-Feng, Zhu Yue-Yong, Li You-Bing
Department of Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China.
Institute of Neurology, University College London, London WC1N 3BG, United Kingdom.
World J Gastroenterol. 2021 Jan 28;27(4):336-344. doi: 10.3748/wjg.v27.i4.336.
Metabolic associated fatty liver disease (MAFLD) is a novel concept proposed in 2020.
To compare the characteristics of MAFLD and MAFLD with hepatitis B virus (HBV) infection.
Patients with histopathologically proven MAFLD from a single medical center were included. Patients were divided into MAFLD group (without HBV infection) and HBV-MAFLD group (with HBV infection). Propensity score matching was utilized to balance the baseline characteristics between two groups.
A total of 417 cases with MAFLD were included, 359 (86.1%) of whom were infected with HBV. There were significantly more males in the HBV-MAFLD group than in the MAFLD group ( < 0.05). After propensity score matching, 58 pairs were successfully matched with no significant differences found in gender, age, body mass index, lipid levels, liver enzymes, and the other metabolic associated comorbidities between the two groups ( > 0.05). The rank sum test results showed that the degree of liver steatosis in the MAFLD group was more severe than that in the HBV-MAFLD group, while the degree of inflammation and fibrosis in the liver was less severe ( < 0.05). In multivariate analysis, HBV infection was associated with significantly lower grade of hepatic steatosis [odds ratio (OR) = 0.088, 95% confidence interval (CI): 0.027-0.291] but higher inflammation level (OR = 4.059, 95%CI: 1.403-11.742) and fibrosis level (OR = 3.016, 95%CI: 1.087-8.370) after adjusting for age, gender, and other metabolic parameters.
HBV infection is associated with similar metabolic risks, lower steatosis grade, higher inflammation, and fibrosis grade in MAFLD patients.
代谢相关脂肪性肝病（MAFLD）是2020年提出的一个新概念。
比较MAFLD及合并乙型肝炎病毒（HBV）感染的MAFLD的特征。
纳入来自单一医疗中心经组织病理学证实为MAFLD的患者。患者分为MAFLD组（无HBV感染）和HBV-MAFLD组（有HBV感染）。采用倾向评分匹配法平衡两组间的基线特征。
共纳入417例MAFLD患者，其中359例（86.1%）感染HBV。HBV-MAFLD组男性明显多于MAFLD组（<0.05）。倾向评分匹配后，成功匹配58对，两组间在性别、年龄、体重指数、血脂水平、肝酶及其他代谢相关合并症方面无显著差异（>0.05）。秩和检验结果显示，MAFLD组肝脂肪变性程度比HBV-MAFLD组更严重，而肝脏炎症和纤维化程度较轻（<0.05）。多因素分析中，在校正年龄、性别和其他代谢参数后，HBV感染与肝脂肪变性分级显著降低[比值比（OR）=0.088，95%置信区间（CI）：0.027 - 0.291]但炎症水平较高（OR = 4.059，95%CI：1.403 - 11.742）及纤维化水平较高（OR = 3.016，95%CI：1.087 - 8.370）相关。
HBV感染与MAFLD患者相似的代谢风险、较低的脂肪变性分级、较高的炎症和纤维化分级相关。
