代谢综合征对慢性乙型肝炎核心患者临床结局的影响（I）类

StephenW

Dig Dis Sci. 2018 Jun 12. doi: 10.1007/s10620-018-5165-6. [Epub ahead of print]
Effect of Metabolic Syndrome on the Clinical Outcomes of Chronic Hepatitis B Patients with Nucleos(t)ide Analogues Treatment.
Kim NH1, Cho YK2, Kim BI2, Kim HJ3.
Author information

1
    Preventive Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
2
    Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-Ro, Jongno-Gu, Seoul, 03181, Korea.
3
    Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-Ro, Jongno-Gu, Seoul, 03181, Korea. [email protected].

Abstract
BACKGROUND:

No data are available about the effect of MS on oral nucleos(t)ide analogues (NUCs) treatment and clinical outcomes in chronic hepatitis B (CHB) patients.
AIMS:

We aimed to elucidate whether coexistence of MS and CHB affects the long-term prognosis of CHB patients with oral NUCs treatment.
METHODS:

We performed a retrospective data analysis for a total of 587 CHB patients who started oral NUCs treatment for the first time in our institution from January 2006 to March 2016.
RESULTS:

Among the 587 patients, 70 (11.9%) had MS, but 517 (88.1%) had no evidence of MS when oral NUCs treatment was initiated. Cumulative occurrence rates of viral breakthrough, genotypic resistance, HCC, disease progression (PD), and overall adverse outcomes (OAO) were significantly higher in CHB patients with MS than in those without MS, although HBV-DNA suppression and cumulative occurrence rates of HBeAg negative conversion and seroconversion were not significantly different between the two groups. The overall survival (OS) was also significantly shorter in CHB patients with MS than in those without MS. Multivariate analysis indicated that the MS was an independent, poor prognostic factor for occurrence of genotypic resistance (adjusted hazard ratio [aHR], 22.3; 95% confidence interval [CI] 6.61-75.02; P < 0.001), HCC (aHR, 3.98; 95% CI 2.07-7.66; P < 0.001), PD (aHR, 6.18; 95% CI 3.43-11.14; P < 0.001), OAO (aHR, 8.10; 95% CI 4.68-14.02; P < 0.001), and OS (aHR, 12.29; 95% CI 2.25-67.24; P < 0.001).
CONCLUSIONS:

MS is an independent determinant of poor prognosis in CHB patients receiving oral NUCs treatment.
KEYWORDS:

Disease progression; Hepatocellular carcinoma; Metabolic syndrome; Nucleos(t)ide analogue; Survival

PMID:
    29948568
DOI:
    10.1007/s10620-018-5165-6

StephenW

Dig Dis Sci。 2018年6月12日，doi：10.1007 / s10620-018-5165-6。 [电子版提前打印]
代谢综合征对慢性乙型肝炎核心患者临床结局的影响（I）类似物治疗。
Kim NH1，Cho YK2，Kim BI2，Kim HJ3。
作者信息

1
    韩国首尔Sungkyunkwan大学医学院三星康宝医院预防保健中心。
2
    消化内科，内科，江北三星医院，医学院的成均馆大学学院，29，Saemunan-RO，钟路区首尔，03181，韩系科。
3
    消化内科，内科，江北三星医院，医学院的成均馆大学学院，29，Saemunan-RO，钟路区首尔，03181，韩系科。 [email protected]。

摘要
背景：

没有关于MS对慢性乙型肝炎（CHB）患者的口服核苷（t）类似物（NUC）治疗和临床结果的影响的数据。
目的：

我们希望阐明MS和CHB共存是否影响口服NUCs治疗的CHB患者的长期预后。
方法：

我们对2006年1月至2016年3月在我院首次开始口服NUC治疗的共587例CHB患者进行了回顾性数据分析。
结果：

在587例患者中，70例（11.9％）有MS，但517例（88.1％）在口服NUCs治疗开始时无MS证据。的病毒突破，基因型耐药，HCC，疾病进展（PD），和总体不良后果（OAO）累积发生率分别为慢性乙型肝炎患者显着更高的与MS比没有MS德CES，尽管HBV DNA抑制和HBeAg的累积发生率两组之间的负转换和血清转换没有显着差异。 CHB患者的总生存期（OS）也短于无MS患者。多变量分析表明阙LA MS在用于基因型耐药的发生独立的，不良预后因素（调整后的危险比[AHR]，22.3; 95％置信区间[CI] 6.61-75.02; P <0.001），HCC（AHR，3.98; 95％CI 2.07-7.66; P <0.001），PD（AHR，6.18; 95％CI 3.43-11.14; P <0.001），OAO（AHR，8.10; 95％CI 4.68-14.02; P <0.001），和OS （aHR，12.29,95％CI 2.25-67.24，P <0.001）。
结论：

MS是接受口服NUC治疗的慢性乙型肝炎患者不良预后的独立决定因素。
关键词：

疾病进展;肝细胞癌;代谢综合征; Nucleos（t）ide类似物;生存

结论：
    29948568
DOI：
    10.1007 / s10620-018-5165-6