慢性乙型肝炎和代谢危险因素：呼吁进行严格的纵向研究

StephenW

World J Gastroenterol. 2019 Jan 21;25(3):282-286. doi: 10.3748/wjg.v25.i3.282.
Chronic hepatitis B and metabolic risk factors: A call for rigorous longitudinal studies.
Seto WK1.
Author information

1
    Department of Medicine, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.

Abstract

Long-term nucleos(t)ide analogue therapy in chronic hepatitis B virus (HBV) infection is effective in suppressing viral replication and reducing liver-related complications. However, HBV-related liver events can still occur in different patient sub-groups. There is emerging evidence that, similar to chronic hepatitis C virus infection, metabolic risk factors may play a role in the disease process of chronic HBV. While the mechanistic nature of metabolic-HBV interactions remains uncertain, studies in different HBV-infected populations have demonstrated that hepatic steatosis, increased body-mass index, diabetes, or a combination of different metabolic risk factors are associated with an increased risk of hepatocellular carcinoma and cirrhosis. The impact of metabolic risk factors is especially prominent in patients with quiescent virological activity, including on-treatment patients with effective viral suppression. As the proportion of on-treatment chronic HBV patients increases worldwide, longitudinal studies determining the relative risks of different metabolic parameters with respect to clinical outcomes are needed. Future studies should also determine if metabolic-directed interventions can improve disease outcomes in chronic HBV.
KEYWORDS:

Body-mass index; Diabetes; Hepatitis B virus; Non-alcoholic fatty liver disease; Obesity; Steatosis

PMID:
    30686897
PMCID:
    PMC6343097
DOI:
    10.3748/wjg.v25.i3.282

StephenW

World J Gastroenterol。 2019年1月21日; 25（3）：282-286。 doi：10.3748 / wjg.v25.i3.282。
慢性乙型肝炎和代谢危险因素：呼吁进行严格的纵向研究。
濑户WK1。
作者信息

1
    香港大学玛丽医院香港大学医学系。

抽象

慢性乙型肝炎病毒（HBV）感染的长期核苷（酸）类似物治疗可有效抑制病毒复制并减少肝脏相关并发症。然而，HBV相关的肝脏事件仍然可以发生在不同的患者亚组中。有新的证据表明，与慢性丙型肝炎病毒感染相似，代谢危险因素可能在慢性HBV的发病过程中发挥作用。虽然代谢 -  HBV相互作用的机制性质仍然不确定，但不同HBV感染人群的研究表明，肝脏脂肪变性，体重指数增加，糖尿病或不同代谢危险因素的组合与肝细胞癌风险增加有关和肝硬化。代谢危险因素的影响在静息病毒学活动的患者中尤为突出，包括有效病毒抑制的治疗患者。随着全球治疗慢性HBV患者比例的增加，需要进行纵向研究，以确定不同代谢参数相对于临床结果的相对风险。未来的研究还应确定代谢指导的干预措施是否可以改善慢性HBV的疾病预后。
关键词：

体重指数;糖尿病;乙型肝炎病毒;非酒精性脂肪性肝病;肥胖;脂肪变性

结论：
    30686897
PMCID：
    PMC6343097
DOI：
    10.3748 / wjg.v25.i3.282