Hepatitis B virus infection and fatty liver in the general population

StephenW

http://www.sciencedirect.com/science/article/pii/S0168827811007756
Research Article
Hepatitis B virus infection and fatty liver in the general population

• Vincent Wai-Sun Wong1, 2,
• Grace Lai-Hung Wong1, 2,
• Winnie Chiu-Wing Chu1, 3, , ,
• Angel Mei-Ling Chim1, 2,
• Arlinking Ong1, 2, 4,
• David Ka-Wai Yeung5,
• Karen Kar-Lum Yiu1, 2,
• Shirley Ho-Ting Chu1, 2,
• Hoi-Yun Chan1, 2,
• Jean Woo2,
• Francis Ka-Leung Chan1, 2,
• Henry Lik-Yuen Chan1, 2, ,
  

• 1 Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
• 2 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
• 3 Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong
• 4 Department of Medicine, Section of Gastroenterology, University of Santo Tomas Hospital, Espana Manila, Philippines
• 5 Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong
  

• Received 27 May 2011. Revised 23 August 2011. Accepted 21 September 2011. Available online 22 October 2011.
  

• http://dx.doi.org/10.1016/j.jhep.2011.09.013, How to Cite or Link Using DOI
  

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Background & Aims

In animal studies, expression of hepatitis B virus (HBV) proteins causes hepatic steatosis. We aimed to study the prevalence of fatty liver in people with and without HBV infection in the general population.

Methods

We performed a cross-sectional population study in Hong Kong Chinese. Intrahepatic triglyceride content (IHTG) was measured by proton-magnetic resonance spectroscopy.

Results

One thousand and thirteen subjects (91 HBV patients and 922 controls) were recruited. The median IHTG was 1.3% (0.2–33.3) in HBV patients and 2.1% (0–44.2) in controls (p <0.001). Excluding subjects with significant alcohol consumption, the prevalence of nonalcoholic fatty liver disease was 13.5% (95% confidence interval [CI] 6.4%, 20.6%) in HBV patients and 28.3% (95% CI 25.3%, 31.2%) in controls (p = 0.003). The fatty liver prevalence differed in HBV patients and controls aged 40–59 years but was similar in those aged 60 years or above. After adjusting for demographic and metabolic factors, HBV infection remained an independent factor associated with lower risk of fatty liver (adjusted odds ratio 0.42; 95% CI 0.20, 0.88; p = 0.022). HBV patients also had a lower prevalence of metabolic syndrome (11.0% vs. 20.2%; p = 0.034), but the difference was mainly attributed to lower triglyceride levels. Among HBV patients, viral genotypes, HBV DNA level and hepatitis B e antigen status were not associated with fatty liver.

Conclusions

HBV infection is associated with a lower prevalence of fatty liver, hypertriglyceridemia and metabolic syndrome. Viral replication may affect lipid metabolism and this warrants further studies.

Abbreviations

• Anti-HBe, antibody against hepatitis B e antigen;
• CI, confidence interval;
• HBeAg, hepatitis B e antigen;
• HBV, hepatitis B virus;
• HBx, hepatitis B X;
• NAFLD, nonalcoholic fatty liver disease;
• 1H-MRS, proton-magnetic resonance spectroscopy
  

Keywords

• Nonalcoholic fatty liver disease;
• Nonalcoholic steatohepatitis;
• Obesity;
• Diabetes mellitus;
• Hypertriglyceridemia;
• Cross-sectional study
  

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StephenW

研究文章
B型肝炎病毒感染，并在一般人群中脂肪肝

    文森特围太阳Wo​​ng1，2，
    格雷斯赖红Wong1，2，
    温妮照荣初1，3，通讯作者的联系信息，电子邮件的通讯作者，
    天使美玲Chim1，2，
    Arlinking Ong1，2，4，
    大卫家围Yeung5
    卡伦家绥Yiu1，2，
    雪莉何挺初1，2，
    海运Chan1，2，
    让Woo2
    弗朗西斯嘉亮Chan1，2，
    亨利力源Chan1，2，通讯作者的联系信息，电子邮件通讯作者

    1消化疾病研究所，香港中文大学，香港
    2，香港，香港中文大学内科及药物治疗学系
    3影像科，介入放射学，香港，香港中文大学
    4医学系，组，西班牙，菲律宾马尼拉大学圣托马斯医院消化科
    临床肿瘤学，香港中文大学，香港5部

    2011年5月收到了27。 2011年8月23日。 2011年9月21日接受。 2011年10月22日。

    http://dx.doi.org/10.1016/j.jhep.2011.09.013，

   

背景与目的

在动物实验中，B型肝炎病毒（HBV）的蛋白质的表达会导致脂肪肝。我们的目的是研究在与乙肝病毒感染的人在总人口中，脂肪肝的患病率。
方法

我们进行了一项横断面人口在香港的中国研究。肝内甘油三酯含量（IHTG）是由质子核磁共振光谱测量。
结果

被招募一千十三科（91乙肝患者和922名对照）。中位数IHTG为1.3％（0.2-33.3），乙肝患者和对照组的2.1％（0-44.2）（P <0.001）。除大量饮酒者，非酒精性脂肪性肝病的患病率为13.5％（95％信心区间[CI]为6.4％，20.6％）在慢性乙型肝炎患者和对照组的28.3％（95％CI为25.3％，31.2％）（ P = 0.003）。脂肪肝的患病率不同的年龄在40-59岁的乙肝患者和控制，但类似的是那些年龄在60岁或以上。乙肝病毒感染的人口和代谢因素调整后，仍然是一个独立的因素与脂肪肝的风险较低（校正胜算比0.42; 95％CI为0.20，0.88，P = 0.022）相关。乙肝患者也有代谢综合征的患病率较低（11.0％比20.2％; P = 0.034），但这种差异主要是由于降低甘油三酯水平。在乙肝患者中，病毒基因型，HBV DNA水平和B型肝炎e抗原状态是不相关的脂肪肝。
结论

乙肝病毒感染相关的脂肪肝，高甘油三酯血症和代谢综合征的患病率较低。病毒复制可能会影响血脂代谢，这是值得进一步研究。
缩略语

    抗-HBe，抗乙肝e抗原的抗体;
    CI，置信区间;
    e抗原，乙型肝炎e抗原;
    乙肝病毒，乙肝病毒;
    HBx基因，肝炎B X当前;
    非酒精性脂肪肝，非酒精性脂肪肝疾病;
    1H-MRS，质子磁共振波谱

关键词

    非酒精性脂肪肝疾病;
    非酒精性脂肪性肝炎;
    肥胖;
    糖尿病;
    高甘油三酯血症;
    横断面研究