Jespersen Sofie, Fritt-Rasmussen Asmita, Madsbad Sten, Pedersen Bente K, Krogh-Madsen Rikke, Weis Nina
Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.
Centre for Physical Activity Research, Copenhagen University Hospital, Rigshospitalet, Denmark.
World J Hepatol. 2025 Jan 27;17(1):97797. doi: 10.4254/wjh.v17.i1.97797.
Chronic hepatitis B (CHB) affects > 300 million people worldwide. The combination of CHB and cardiometabolic co-morbidities increases the risk of liver-related morbidity and mortality. However, international guidelines for CHB treatment do not provide recommendations for follow-up examinations or treatment of patients with CHB and cardiometabolic comorbidities. In studies investigating cardiometabolic co-morbidity in patients with CHB, inconsistent findings have been observed, and both lower and higher prevalence of cardiometabolic co-morbidities compared to the general population have been reported. It is unclear whether patients with CHB living in Denmark have an increased prevalence of cardiometabolic co-morbidities.
To investigate the prevalence of cardiometabolic comorbidities in patients with CHB and matched non-CHB comparison group.
We examined patients with CHB and age-, sex-, body mass index (BMI)-, and country-of-birth matched comparison group. Defining cardiometabolic co-morbidity: Obesity (BMI > 25 kg/m/abnormal waist-to-hip ratio), metabolic dysfunction-associated steatotic liver disease (MASLD), hypercholesterolemia (total-cholesterol > 5 mmol/L/statin use), hypertension (systolic ≥ 135 mmHg/ diastolic ≥ 85 mmHg/antihypertensive medication) and type 2 diabetes (T2D) (2-hour oral glucose tolerance test glucose > 11.1 mmol/L/HbA1c > 48 mmol/mol/ antidiabetic medication). Physical activity was evaluated using maximal oxygen consumption (VOmax), activity monitors, and a questionnaire.
We included 98 patients with CHB and 49 persons in the comparison group. The two groups were well-matched, showing no significant differences in age, sex, BMI, country-of-birth, education, or employment. Among patients with CHB, the following prevalence of cardiometabolic co-morbidity was found: 77% were obese, 45% had MASLD, 38% had hypercholesterolemia, 26% had hypertension, and 7% had T2D, which did not differ significantly from the comparison group, apart from lower prevalence of hemoglobin A1c (HbA1c) ≥ 48 mmol/L or known T2D. Both groups had low VOmax of 27 mL/kg/minute in the patients with CHB and 30 mL/kg/minute in the comparison group, and the patients with CHB had a shorter self-assessed sitting time.
The patients with CHB and the comparison group were well-matched and had a similar prevalence of cardiometabolic comorbidities. Furthermore, both groups had low levels of physical fitness.
慢性乙型肝炎（CHB）在全球影响着超过3亿人。CHB与心脏代谢合并症并存会增加肝脏相关发病和死亡的风险。然而，CHB治疗的国际指南并未针对CHB合并心脏代谢合并症患者的随访检查或治疗提供建议。在调查CHB患者心脏代谢合并症的研究中，观察到了不一致的结果，与普通人群相比，心脏代谢合并症的患病率既有较低的情况，也有较高的情况。尚不清楚丹麦的CHB患者心脏代谢合并症的患病率是否增加。
调查CHB患者及匹配的非CHB对照组中心脏代谢合并症的患病率。
我们检查了CHB患者以及年龄、性别、体重指数（BMI）和出生国家相匹配的对照组。定义心脏代谢合并症：肥胖（BMI>25kg/m²/腰臀比异常）、代谢功能障碍相关脂肪性肝病（MASLD）、高胆固醇血症（总胆固醇>5mmol/L/使用他汀类药物）、高血压（收缩压≥135mmHg/舒张压≥85mmHg/使用抗高血压药物）和2型糖尿病（T2D）（口服葡萄糖耐量试验2小时血糖>11.1mmol/L/HbA1c>48mmol/mol/使用抗糖尿病药物）。使用最大耗氧量（VOmax）、活动监测器和问卷评估身体活动情况。
我们纳入了98例CHB患者和49例对照组人员。两组匹配良好，在年龄、性别、BMI、出生国家、教育程度或就业方面无显著差异。在CHB患者中，发现心脏代谢合并症的患病率如下：77%肥胖，45%患有MASLD，38%患有高胆固醇血症，26%患有高血压，7%患有T2D，与对照组相比无显著差异，只是血红蛋白A1c（HbA1c）≥48mmol/L或已知T2D的患病率较低。两组的VOmax均较低，CHB患者为27mL/kg/分钟，对照组为30mL/kg/分钟，且CHB患者自我评估的久坐时间较短。
CHB患者与对照组匹配良好，心脏代谢合并症的患病率相似。此外两组的身体素质水平均较低。
