Liu Chang-Hai, Jiang Wei, Wu Dong-Bo, Zeng Qing-Min, Wang You-Juan, Tang Hong
Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China.
Division of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Disease, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
Dig Dis Sci. 2023 Apr;68(4):1605-1614. doi: 10.1007/s10620-022-07695-2. Epub 2022 Oct 13.
The association between hepatitis B and concomitant diseases, such as fatty liver, T2DM, MetS, and Hp infection, remains unclear.
The present study was to illustrate the association and explore the co-contribution on abnormal transaminase and progression of liver stiffness.
A total of 95,998 participants underwent HBsAg screening in West China Hospital from 2014 to 2017. Multivariable logistic regression was used to determine the adjusted odds ratios.
The prevalence of HBsAg-positive rate was 8.30% of our included study population. HBsAg positive was associated with negative risk of fatty liver (odds ratio [OR] 0.71, 95% confidence interval [CI] 0.65-0.78, p < 0.001) and MetS (OR 0.74, 95% CI 0.67-0.84, p < 0.001), and with positive risk of Hp infection (OR 1.09, 95% CI 1.02-1.17, p = 0.012) and T2DM (OR 1.18, 95% CI 1.01-1.40, p = 0.043). Besides, HBsAg-positive patients with T2DM had higher risk of elevated ALT (OR 2.09, 95% CI 1.69-2.83, p < 0.001 vs OR 1.59, 95% CI 1.51-1.68, p < 0.001), AST (OR 2.69, 95% CI 1.98-3.65, p < 0.001 vs OR 1.89, 95% CI 1.76-2.02, p < 0.001) than HBV alone. In addition to HBV, T2DM also can increase the risk of liver fibrosis (OR 3.23, 95% CI 1.35-7.71, p = 0.008) and cirrhosis (OR 4.31, 95% CI 1.41-13.20, p = 0.010).
Hepatitis B patients have a lower risk of fatty liver and MetS, and a higher risk of T2DM and Hp infection. Besides, T2DM might be possibly associated with abnormal liver transaminase and fibrosis progression in HBsAg-positive patients.
乙型肝炎与脂肪肝、2型糖尿病、代谢综合征和幽门螺杆菌感染等伴随疾病之间的关联尚不清楚。
本研究旨在阐明这种关联，并探讨其对转氨酶异常和肝硬度进展的共同影响。
2014年至2017年，共有95998名参与者在华西医院接受了乙肝表面抗原筛查。采用多变量逻辑回归分析来确定调整后的比值比。
在我们纳入的研究人群中，乙肝表面抗原阳性率为8.30%。乙肝表面抗原阳性与脂肪肝的负风险（比值比[OR]0.71，95%置信区间[CI]0.65-0.78，p<0.001）和代谢综合征（OR 0.74，95%CI 0.67-0.84，p<0.001）相关，与幽门螺杆菌感染的正风险（OR 1.09，95%CI 1.02-1.17，p=0.012）和2型糖尿病（OR 1.18，95%CI 1.01-1.40，p=0.043）相关。此外，合并2型糖尿病的乙肝表面抗原阳性患者谷丙转氨酶升高的风险更高（OR 2.09，95%CI 1.69-2.83，p<0.001，而单纯乙肝患者为OR 1.59，95%CI 1.51-1.68，p<0.001），谷草转氨酶升高的风险也更高（OR 2.69，95%CI 1.98-3.65，p<0.001，而单纯乙肝患者为OR 1.89，95%CI 1.76-2.02，p<0.001）。除乙肝外，2型糖尿病还会增加肝纤维化（OR 3.23，95%CI 1.35-7.71，p=0.008）和肝硬化（OR 4.31，95%CI 1.41-13.20，p=0.010）的风险。
乙肝患者患脂肪肝和代谢综合征的风险较低，患2型糖尿病和幽门螺杆菌感染的风险较高。此外，2型糖尿病可能与乙肝表面抗原阳性患者的肝脏转氨酶异常和纤维化进展有关。
