慢性乙型肝炎患者完全抑制病毒后，体重指数的纵向变化与

StephenW

Longitudinal Change of Body Mass Index Is Associated With Alanine Aminotransferase Elevation After Complete Viral Suppression in Chronic Hepatitis B Patients
Kaifeng Wang, Weiyin Lin, Zhe Kuang, Rong Fan, Xieer Liang, Jie Peng, Yabing Guo, Jinjun Chen, Zhihong Liu, Xiaoyun Hu ... Show more
The Journal of Infectious Diseases, Volume 220, Issue 9, 1 November 2019, Pages 1469–1476, https://doi.org/10.1093/infdis/jiz326
Published:
02 August 2019
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Abstract
Background

Little is known about cause and intervention for alanine aminotransferase (ALT) elevation after complete viral suppression in patients with chronic hepatitis B (CHB).
Methods

In this prospective cohort study, patients with CHB who were treated with nucleos(t)ide analogs and maintained undetectable levels of hepatitis B virus (HBV) deoxyribonucleic acid (DNA) for at least 6 months were enrolled. Patients were followed up at 6-month intervals, and anthropometric, biochemical, and virological assessments were performed.
Results

Of 1965 patients with median follow-up of 18.36 months, one third of patients experienced ALT elevation. Baseline high body mass index ([BMI] defined as ≥25 kg/m2), younger age, and liver cirrhosis independently increased the risk of longitudinal ALT elevation. At the end of follow-up, 89 (4.8%) patients reverted to low BMI, and 92 (5.0%) developed to high BMI. Compared with persistent high BMI, reversion to low BMI reduced the risk of ALT elevation (adjusted odds ratio [aOR], 0.38; 95% confidence interval [CI], 0.19–0.77); compared with persistent low BMI, onset of high BMI increased the risk of ALT elevation (aOR, 1.78; 95% CI, 1.02–3.11).
Conclusions

High BMI is an independent predictor for ALT elevation after complete HBV DNA suppression. Improvement of BMI may have a beneficial effect on ALT normalization and even long-term outcomes.

StephenW

慢性乙型肝炎患者完全抑制病毒后，体重指数的纵向变化与丙氨酸氨基转移酶升高有关
王开峰，林伟音，匡匡，范荣，谢谢亮，彭杰，郭亚兵，陈金军，刘志宏，胡晓云...显示更多
传染病杂志，第220卷，第9期，2019年11月1日，第1469-1476页，https：//doi.org/10.1093/infdis/jiz326
发布时间：
2019年8月2日
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抽象
背景

关于慢性乙型肝炎（CHB）患者完全抑制病毒后丙氨酸氨基转移酶（ALT）升高的原因和干预措施知之甚少。
方法

在这项前瞻性队列研究中，纳入了接受核苷（核苷酸）类似物治疗并保持至少6个月无法检测到的乙型肝炎病毒（HBV）脱氧核糖核酸（DNA）水平的CHB患者。每隔6个月对患者进行一次随访，并进行人体测量，生化和病毒学评估。
结果

1965年中位随访时间为18.36个月的患者中，三分之一的患者出现ALT升高。基线高体重指数（[BMI]定义为≥25kg / m2），年龄较小和肝硬化独立增加了纵向ALT升高的风险。随访结束时，有89名（4.8％）患者恢复为低BMI，有92名（5.0％）患者发展为高BMI。与持续的高BMI相比，恢复为低BMI可以降低ALT升高的风险（校正比值比[aOR]为0.38； 95％置信区间[CI]为0.19-0.77）；与持续的低BMI相比，高BMI的发作增加了ALT升高的风险（aOR，1.78； 95％CI，1.02-3.11）。
结论

高BMI是完全抑制HBV DNA后ALT升高的独立预测因子。 BMI的改善可能对ALT正常化甚至长期结果具有有益的影响。