Hepatitis B virus infection and risk of non‐alcoholic fatty liver disease: A population‐based cohort study
Liguo Zhu
Jie Jiang
Xiangjun Zhai
Aileen Baecker
Hong Peng
Jiao Qian
MingHao Zhou
Ci Song
Yan Zhou
Jianfang Xu
Hongjian Liu
Dong Hang
Zhibin Hu
Hongbin Shen
… See all authors
First published: 19 July 2018 https://doi.org/10.1111/liv.13933
Funding informationThis work was supported by National Natural Science Foundation of China [81502861, 81673244]; National Major S&T Projects [2009ZX10004‐904, 2011ZX10004‐902, 2013ZX10004‐905]; Foundation for the National Institutes of Health [T32CA009142]; Chinese Foundation for Hepatitis Prevention and Control—TianQing Liver Disease Research Fund Subject [TQGB20140221]; Jiangsu Health International Exchange Program; Jiangsu Province Science & Technology Demonstration Project for Emerging Infectious Diseases Control and Prevention (BE2015714); Jiangsu Province Health Development Project with Science and Education (QNRC2016546).
Liguo Zhu and Jie Jiang contributed equally to this work.
Handling Editor: Helena Cortez‐Pinto
Trial registration number: None.
Abstract
Background & aims
Although non‐alcoholic fatty liver disease (NAFLD) has been studied extensively, the potential risk factors for NAFLD among chronic hepatitis B (CHB) patients have not been fully known.
Methods
A population‐based cohort of adult CHB patients without a history of alcohol drinking or NAFLD were recruited and followed up from October 2012 to January 2015 in Jiangsu province, China. Using Cox proportional hazards regression model, potential risk factors including viral and metabolic factors for NAFLD were evaluated.
Results
Two thousand three hundred and ninety‐three adult CHB patients (mean age 50.7 ± 13.2 years) were included in the cohort. With 4429 person‐years of follow‐up, 283 individuals progressed to NAFLD with an incidence rate of 63.89/1000 person‐years. Overweight and obese CHB patients had an increased risk of NAFLD (overweight adjusted hazard ratio [HR], 3.10; 95% CI, 2.29‐4.18; obese HR, 8.52; 95%CI, 5.93‐12.25) compared to normal weight carriers. The incidence of NAFLD was associated with concurrent type 2 diabetes mellitus (DM) (HR, 1.88; 95%CI, 1.15‐3.08). However, no associations between viral factors with NAFLD incidence rate were identified. In a subgroup of participants with concurrent type 2 DM, detectable HBV DNA levels were negatively associated with the development of NAFLD (HR, 0.37; 95%CI, 0.14‐0.98). There was super‐multiplicative interaction between BMI and gender with respect to incidence of NAFLD, with an ROR of 2.08 (95%CI, 1.02‐4.23).
Conclusion
Metabolic factors play an important role in the presence of NAFLD among Chinese CHB patients. However, viral replication factors are not related to NAFLD except among those with concurrent type 2 DM. 作者: StephenW 时间: 2018-8-22 18:03