Van Training and Research Hospital, Infectious Disease and Clinical Microbiology, Van, Turkey; Bursa Yuksek Ihtisas Training and Research Hospital, Infectious Disease and Clinical Microbiology, Bursa, Turkey.
Van Training and Research Hospital, Infectious Disease and Clinical Microbiology, Van, Turkey; Dıskapı Yıldırım Beyazıt Training and Research Hospital, Infectious Disease and Clinical Microbiology, Ankara, Turkey.
Arab J Gastroenterol. 2023 Feb;24(1):11-15. doi: 10.1016/j.ajg.2022.05.002. Epub 2022 Jun 7.
The current study aimed to investigate the frequency of hepatic steatosis in chronic hepatitis B (CHB) patients and determine the possible risk factors associated with its presence.
This cross-sectional study retrospectively evaluated the medical records of 255 adult CHB patients visiting an infectious disease outpatient clinic. Patients with hepatitis B surface antigen positivity for >6 months and those who did not receive antiviral therapy were included in the study. The presence and stage of hepatic steatosis were determined through hepatobiliary ultrasonography.
The mean age of the patients was 40.6 ± 12.7 years. Hepatic steatosis was detected in 44.4 % of the patients through ultrasound imaging. Our findings showed that the detected steatosis prevalence in our patients with CHB was significantly higher compared to the highest prevalence of non-alcoholic steatohepatitis found in the general Turkish population (19.9 %) [RR 2.23 (1.75-2.86), p < 0.001]. CHB patients with steatosis had significantly higher age, triglyceride, and gamma-glutamyl transferase levels than those without steatosis (p < 0.05). No significant association was found between the presence of steatosis, sex, liver function test results, and platelet, alkaline phosphatase, cholesterol, alpha fetoprotein, or HBV-DNA levels. No significant relationship was found between aspartate aminotransferase (AST)/platelet ratio index (APRI) and steatosis was examined (p > 0.05). Post-hoc analysis showed a significant relationship between HBV-DNA levels and ALT, AST, and APRI scores.
Our data showed that hepatic steatosis is more common in CHB patients than in the general population. Older age and high triglyceride levels increased the risk of hepatic steatosis in CHB patients, consequently increasing GGT levels, which are indicative of liver damage, in these patients.
本研究旨在调查慢性乙型肝炎(CHB)患者中肝脂肪变性的频率,并确定与其存在相关的可能危险因素。
这项横断面研究回顾性评估了 255 名在传染病门诊就诊的成年 CHB 患者的病历。纳入标准为乙型肝炎表面抗原阳性>6 个月且未接受抗病毒治疗的患者。通过肝胆超声检查确定肝脂肪变性的存在和分期。
患者的平均年龄为 40.6±12.7 岁。通过超声成像发现 44.4%的患者存在肝脂肪变性。我们的研究结果表明,与土耳其普通人群中非酒精性脂肪性肝炎的最高患病率(19.9%)相比,我们的 CHB 患者中检测到的脂肪变性患病率显著更高[RR 2.23(1.75-2.86),p<0.001]。患有脂肪变性的 CHB 患者的年龄、甘油三酯和γ-谷氨酰转移酶水平显著高于无脂肪变性的患者(p<0.05)。脂肪变性的存在与性别、肝功能试验结果、血小板、碱性磷酸酶、胆固醇、甲胎蛋白或 HBV-DNA 水平之间无显著相关性。未发现脂肪变性与天门冬氨酸氨基转移酶(AST)/血小板比值指数(APRI)之间存在显著关系(p>0.05)。事后分析显示 HBV-DNA 水平与 ALT、AST 和 APRI 评分之间存在显著关系。
我们的数据表明,CHB 患者中肝脂肪变性比普通人群更为常见。年龄较大和甘油三酯水平升高增加了 CHB 患者发生肝脂肪变性的风险,进而导致这些患者的 GGT 水平升高,这表明存在肝损伤。