Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, USA.
Department of Hepatology, Hepatology Research institute, the First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
Aliment Pharmacol Ther. 2021 Nov;54(9):1100-1109. doi: 10.1111/apt.16595. Epub 2021 Sep 1.
As the prevalence of hepatitis steatosis (HS) increases, the prevalence of HS among those with chronic hepatitis B (CHB) may also be increasing but data on the effect of HS on CHB disease progression are lacking.
To determine the prevalence of HS in CHB and associated factors, prevalence of fibrosis and its association with HS.
Two researchers independently searched the literature and extracted data. We included full-length original articles of adults with CHB that evaluated. Prevalence estimates were pooled using a random-effects model. Associations between HS and fibrosis were assessed by pooled odds ratios (ORs) or mean differences (MD).
Of the 2821 records screened, 54 eligible studies (28 648 patients) were analysed. The pooled prevalence of HS in CHB was 32.8% (95% CI, 28.9-37.0) with higher prevalence in men and obese patients. Older age, male sex and metabolic factors were associated with HS while an inverse association was observed between HS and HBeAg (OR 0.82, 95% CI, 0.75-0.91) and HBV DNA levels (MD -0.38, 95% CI -1.16--0.42). The pooled prevalence of significant fibrosis (≥F2 or ≥F3) was similar between patients with CHB with or without HS (40.1% vs 42.22%, P = 0.68). HS was not significantly associated with fibrosis (pooled OR 0.87, 95% CI 0.54-1.39, 20 studies, 6232 patients).
Approximately 30% of patients with CHB had HS, which was positively associated with male sex, diabetes and metabolic factors, and was negatively associated with HBeAg and HBV DNA. HS was not significantly associated with increased fibrosis.
随着脂肪性肝炎（HS）的患病率增加，慢性乙型肝炎（CHB）患者中 HS 的患病率也可能在增加，但缺乏 HS 对 CHB 疾病进展影响的数据。
确定 CHB 中 HS 的患病率及相关因素、纤维化的患病率及其与 HS 的关系。
两名研究人员独立进行文献检索和数据提取。我们纳入了评估成人 CHB 的全文原始文章。使用随机效应模型汇总患病率估计值。使用汇总优势比（OR）或均数差（MD）评估 HS 与纤维化之间的关系。
在筛选的 2821 条记录中，有 54 项符合条件的研究（28648 例患者）进行了分析。CHB 中 HS 的总患病率为 32.8%（95%CI，28.9-37.0），男性和肥胖患者的患病率更高。年龄较大、男性和代谢因素与 HS 相关，而 HS 与 HBeAg（OR 0.82，95%CI 0.75-0.91）和 HBV DNA 水平（MD-0.38，95%CI-1.16--0.42）呈负相关。有或无 HS 的 CHB 患者中显著纤维化（≥F2 或≥F3）的总患病率相似（40.1%与 42.22%，P=0.68）。HS 与纤维化无显著相关性（汇总 OR 0.87，95%CI 0.54-1.39，20 项研究，6232 例患者）。
约 30%的 CHB 患者存在 HS，HS 与男性、糖尿病和代谢因素呈正相关，与 HBeAg 和 HBV DNA 呈负相关。HS 与纤维化增加无显著相关性。
