[英文研究]B型肝炎病人的脂肪肝-元分析方法

StephenW

<http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2011.06801.x/abstract>

B型肝炎病人的脂肪肝-元分析方法
HEPATIC STEATOSIS IN HEPATITIS B VIRUS INFECTED PATIENTS – META-ANALYSIS
OF RISK FACTORS AND COMPARISON WITH HEPATITIS C INFECTED PATIENTS

Mariana V. Machado1, António G. Oliveira2, Helena Cortez-Pinto1,*

DOI: 10.1111/j.1440-1746.2011.06801.x
© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell
Publishing Asia Pty Ltd Issue

Journal of Gastroenterology and Hepatology
Accepted Article (Accepted, unedited articles published online for future
issues)

ABSTRACT
Although hepatic steatosis (HS) has an association with hepatitis C virus
(HCV) infection, an association with hepatitis B virus (HBV) is
controversial. We performed a meta-analysis to evaluate HS prevalence and
risk factors, in HBV infection. Standard guidelines for performance of
meta-analyses were followed. Studies with HS assessed by histology were
included. Pooled odd ratios (OR) and standardized mean differences (SMD)
were obtained with the random-effects model and DerSimonian-Laid method.
Seventeen out of 21 studies were included, comprising 4100 HBV infected
patients. Overall HS prevalence was 29.6%. Eight studies also included 945
HCV infected patients, showing decreased risk of HS in HBV versus HCV
patients (OR 0.55, 95%CI [0.45-0.67], p < 0.001). In HBV, HS positively
associated with male gender (OR 1.74, 95%CI [1.28-2.38], p < 0.001), body
mass index (SMD 2.17, 95%CI [1.23, 3.11], p < 0.001), obesity (OR 6.59,
95%CI [3.51-12.257], p = 0.003), diabetes (OR 2.62, 95%CI [1.37-4.00], p =
0.004), glycemia (SMD 0.84, 95%CI [0.00, 1.67], p = 0.049), triglycerides
(SMD 1.18, 95%CI [0.48, 1.89], p = 0.001), cholesterol (SMD 0.88, 95%CI
[0.31, 1.45], p = 0.003), moderate alcohol consumption (OR 1.54, 95%CI
[1.10-2.15], p = 0.011) and negatively with HBV DNA (SMD -74.12, 95%CI
[-82.93, -65.31], p < 0.001). HS had no association with aminotransferases,
HBeAg, genotype or hepatic histology, necroinflammation or fibrosis.

Conclusions: HS in HBV seems to be as frequent as in the general
population, and lower than in HCV infected patients, relating to metabolic
factors but not with hepatic histology severity. A puzzling strong negative
association between viral load and HS, may even suggest a protective effect
of the virus on HS.




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StephenW

脂肪肝B型肝炎病毒的病人 - 元分析方法
风险因素和C型肝炎感染者比较

马里亚纳五马查多1，安东尼克奥利维拉2，拿科尔特斯- Pinto1，*

分类号：10.1111/j.1440-1746.2011.06801.x
© 2011年胃肠病学和肝病基金会和Blackwell
亚洲私人有限公司出版发行

胃肠病学和肝病
接受第（接受，为未来网上发表文章未经编辑
问题）

摘要
虽然（房协）与脂肪肝有丙型肝炎病毒协会
（HCV）的感染，乙肝病毒协会（HBV）是
争议。我们进行了荟萃分析，评价和房协流行
风险因素的影响，乙肝病毒感染。性能的标准指引
荟萃分析随访。组织学与房协研究进行评估
包括在内。汇集胜算比（OR）和标准化（SMD）的平均差异
获得了与随机效应模型和合并分析，铺设方法。
十七出来的21项研究都包括在内，其中包括4100 HBV感染
病人。房协的整体盛行率为29.6％。还包括945项研究
丙型肝炎病毒，感染者呈现下降的HBV与HCV的危险房协
患者（或0.55，95％CI为[0.45-0.67]，p值“0.001）。在乙肝病毒，房协积极
与男性有关（或1.74，95％CI为[1.28-2.38]，p值“0.001），体
质量指数（贴片2.17，95％CI为[1.23，3.11]，p值“0.001），肥胖（OR 6.59，
95％CI为[3.51-12.257]，p值= 0.003），糖尿病（OR 2.62，95％CI为[1.37-4.00]，p值=
0.004），血糖（贴片0.84，95％CI为[0.00，1.67]，p值= 0.049），甘油三酯
（贴片1.18，95％CI为[0.48，1.89]，p值= 0.001），胆固醇（贴片0.88，95％CI为
[0.31，1.45]，p值= 0.003），适量饮酒（或1.54，95％CI为
[1.10-2.15]，p值= 0.011），与乙肝病毒脱氧核糖核酸（贴片-74.12，95％CI为
[-82.93，-65.31]，磷“0.001）。房协没有与转氨酶协会
e抗原，基因型或肝组织学，坏死性炎症或纤维化。

结论：在HBV房协似乎是像在频繁的一般
人口和丙型肝炎病毒感染者比低，与之有关的代谢
因素，但不与肝组织学严重程度。令人费解的强烈的负
病毒载量和HS之间的关联，甚至可以提出一个保护作用
关于房协病毒。