结果：在我们纳入的研究人群中，HBsAg 阳性率为 8.30%。 HBsAg 阳性与脂肪肝的负风险相关（优势比 [OR] 0.71, 95% 置信区间 [CI] 0.65-0.78, p < 0.001）和 MetS (OR 0.74, 95% CI 0.67-0.84, p < 0.001) , 并且具有 Hp 感染 (OR 1.09, 95% CI 1.02-1.17, p = 0.012) 和 T2DM (OR 1.18, 95% CI 1.01-1.40, p = 0.043) 的阳性风险。此外，HBsAg 阳性的 T2DM 患者 ALT 升高的风险更高（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) 比单独使用 HBV。除了 HBV，T2DM 还可以增加肝纤维化（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。
Concomitant Diseases and Co-contribution on Progression of Liver Stiffness in Patients with Hepatitis B Virus Infection
Chang-Hai Liu 1 2 , Wei Jiang 1 2 , Dong-Bo Wu 1 2 , Qing-Min Zeng 1 2 , You-Juan Wang 3 , Hong Tang 4 5
Affiliations
Affiliations
1
Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China.
2
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.
3
Health Management Center, West China Hospital of Sichuan University, Chengdu, China.
4
Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China. [email protected].
5
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. [email protected].
PMID: 36227429 DOI: 10.1007/s10620-022-07695-2
Abstract
Background: The association between hepatitis B and concomitant diseases, such as fatty liver, T2DM, MetS, and Hp infection, remains unclear.
Aim: The present study was to illustrate the association and explore the co-contribution on abnormal transaminase and progression of liver stiffness.
Methods: 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.
Results: 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).
Conclusion: 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.