Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Epidemiology, IQVIA, Frankfurt, Germany.
Eur J Clin Invest. 2023 Mar;53(3):e13911. doi: 10.1111/eci.13911. Epub 2022 Nov 30.
Non-alcoholic fatty liver disease (NAFLD) has become the leading cause of liver cirrhosis and hepatocellular carcinoma worldwide. Although various genetic and lifestyle-related risk factors have been identified, its pathophysiology has not yet been fully unravelled. While acute EBV infection in the setting of infectious mononucleosis can lead to acute hepatitis, the long-term hepatic sequelae of infectious mononucleosis are still poorly understood.
This retrospective cohort study included 13,859 patients with and 13,859 matched individuals without infectious mononucleosis from the Disease Analyzer database (IQVIA). Multivariable Cox regression analyses were used to evaluate the association between infectious mononucleosis and NAFLD.
Within 10 years of the index date, 2.64% of patients with infectious mononucleosis and 1.78% of individuals without infectious mononucleosis had been diagnosed with NAFLD (p < .001). The incidence of NAFLD was 263.9 cases per 100,000 person-years among individuals with infectious mononucleosis and 164.5 cases per 100,000 person-years among those without. Multivariable regression analyses indicated that infectious mononucleosis was significantly associated with the incidence of NAFLD (HR: 1.73) both among women (HR: 1.73) and among men (HR: 1.70). In age-stratified analyses, the association between infectious mononucleosis and NAFLD was most pronounced for the groups aged between 41 and 50 years (HR: 2.94) and >50 years (HR: 2.68).
Infectious mononucleosis is significantly associated with the incidence of NAFLD in a large cohort from Germany. These findings suggest a pathophysiological involvement of EBV in the development of NAFLD and could stimulate research efforts to better understand the pathophysiology of this emerging global medical burden.
非酒精性脂肪性肝病（NAFLD）已成为全球肝硬化和肝细胞癌的主要病因。尽管已经确定了各种遗传和生活方式相关的风险因素，但它的病理生理学尚未完全阐明。虽然传染性单核细胞增多症时的急性 EBV 感染可导致急性肝炎，但传染性单核细胞增多症的长期肝脏后遗症仍知之甚少。
这项回顾性队列研究纳入了来自 IQVIA 的疾病分析数据库（Disease Analyzer database）中的 13859 例患有传染性单核细胞增多症的患者和 13859 例匹配的无传染性单核细胞增多症的个体。多变量 Cox 回归分析用于评估传染性单核细胞增多症与 NAFLD 之间的关联。
在索引日期后的 10 年内，2.64%的传染性单核细胞增多症患者和 1.78%的无传染性单核细胞增多症个体被诊断患有 NAFLD（p<0.001）。传染性单核细胞增多症患者中 NAFLD 的发病率为每 100000 人年 263.9 例，无传染性单核细胞增多症患者中为每 100000 人年 164.5 例。多变量回归分析表明，传染性单核细胞增多症与 NAFLD 的发病显著相关（女性：HR=1.73；男性：HR=1.70）。在年龄分层分析中，传染性单核细胞增多症与 NAFLD 之间的关联在 41-50 岁（HR=2.94）和>50 岁（HR=2.68）的年龄组中最为显著。
在德国的一个大型队列中，传染性单核细胞增多症与 NAFLD 的发病率显著相关。这些发现提示 EBV 在 NAFLD 发展中的病理生理学参与，并可能激发研究努力，以更好地理解这一新兴的全球医疗负担的病理生理学。
