Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
Clinical and Translational Hepatology Laboratory, Seongnam, Republic of Korea.
Aliment Pharmacol Ther. 2022 Jan;55(1):97-107. doi: 10.1111/apt.16706. Epub 2021 Nov 24.
Population-based data are lacking regarding whether fatty liver is a risk factor for hepatocellular carcinoma (HCC) and mortality in patients with chronic viral hepatitis.
To investigate the association of fatty liver with HCC incidence and mortality in patients with chronic viral hepatitis using a nationwide cohort METHODS: We included 57,385 patients with chronic hepatitis B (CHB) or chronic hepatitis C (CHC) who underwent health examinations. The patients were divided into three groups: no fatty liver, fatty liver index (FLI) <30, grade 1 (G1) fatty liver: 30≤ FLI <60, and grade 2 (G2) fatty liver: FLI >60.
During a median 8.4-year follow-up, we documented 3496 HCC cases and 4146 deaths. Compared to patients with no fatty liver (n = 35,018), the risk of HCC was significantly higher in patients with G1 fatty liver (n = 14,544) (adjusted hazard ratio [aHR] = 1.50, 95% confidence interval [CI] = 1.38-1.64) and G2 fatty liver (n = 7,823) (aHR = 1.88, 95% CI = 1.67-2.12). The risk of mortality was significantly higher in patients with G1 fatty liver (aHR = 1.53, 95% CI = 1.41-1.66) and G2 fatty liver (aHR = 2.16, 95% CI = 1.94-2.42) compared to patients with no fatty liver.
Concurrent fatty liver was associated with a higher risk of HCC and mortality in patients with chronic viral hepatitis. Our results suggest the importance of management of fatty liver to reduce the risks of HCC and mortality in patients with chronic viral hepatitis.
关于脂肪肝是否是慢性病毒性肝炎患者发生肝细胞癌（HCC）和死亡的危险因素，基于人群的数据尚缺乏。
利用全国性队列研究调查脂肪肝与慢性病毒性肝炎患者 HCC 发生率和死亡率的相关性。
我们纳入了 57385 名接受健康检查的慢性乙型肝炎（CHB）或慢性丙型肝炎（CHC）患者。患者被分为三组：无脂肪肝、脂肪肝指数（FLI）<30、G1 脂肪肝（30≤FLI<60）和 G2 脂肪肝（FLI>60）。
在中位 8.4 年的随访期间，我们记录了 3496 例 HCC 病例和 4146 例死亡病例。与无脂肪肝患者（n=35018）相比，G1 脂肪肝患者（n=14544）（校正后的危险比[aHR]为 1.50，95%置信区间[CI]为 1.38-1.64）和 G2 脂肪肝患者（n=7823）（aHR 为 1.88，95% CI 为 1.67-2.12）发生 HCC 的风险显著更高。与无脂肪肝患者相比，G1 脂肪肝患者（aHR 为 1.53，95% CI 为 1.41-1.66）和 G2 脂肪肝患者（aHR 为 2.16，95% CI 为 1.94-2.42）发生死亡的风险显著更高。
合并脂肪肝与慢性病毒性肝炎患者 HCC 风险和死亡率升高相关。我们的研究结果表明，管理脂肪肝对于降低慢性病毒性肝炎患者 HCC 风险和死亡率至关重要。
