肝脂肪變性對血清丙氨酸轉氨酶水平正常的慢性乙型肝炎患

StephenW

肝脂肪變性對血清丙氨酸轉氨酶水平正常的慢性乙型肝炎患者肝臟硬度測量的影響：一項多中心隊列研究
王曉東，潘成偉，周桂玉，等
病毒性肝炎雜誌|2021 年 12 月 15 日

在血清丙氨酸轉氨酶水平正常的慢性乙型肝炎 (CHB) 患者中，瞬時彈性成像測量的肝臟硬度測量 (LSM) 不受肝臟脂肪變性的顯著影響。

    這項研究涉及 755 名血清丙氨酸轉氨酶水平正常的 CHB 患者，他們接受了振動控制的瞬時彈性成像和肝活檢；其中，286 人 (37.9%) 患有肝脂肪變性。

    發現肝臟脂肪變性的存在與更高的體重指數 (BMI) 和更高的血清總膽固醇和甘油三酯水平獨立相關。

    肝脂肪變性和纖維化階段之間沒有發現顯著聯繫（優勢比 = 1.016）。

    與較高 LSM 獨立相關的因素包括：年齡、BMI、血清 γ-谷氨酰轉肽酶、HBeAg 陽性以及肝纖維化階段和炎症活動等級，而肝脂肪變性程度與 LSM 之間沒有顯著聯繫。

    在組織學纖維化階段相同的情況下，沒有、輕度、中度或重度脂肪變性的患者的 LSM 值沒有顯著差異。

StephenW

Effect of liver steatosis on liver stiffness measurement in chronic hepatitis B patients with normal serum alanine aminotransferase levels: A multicenter cohort study
Wang XD, Pan CW, Zhou GY, et al
Journal of Viral Hepatitis|December 15, 2021

In chronic hepatitis B (CHB) patients with normal serum alanine aminotransferase levels, transient elastography-measured liver stiffness measurement (LSM) is not significantly affected by liver steatosis.

    This study involved 755 CHB patients with normal serum alanine aminotransferase levels, who underwent vibration-controlled transient elastography and liver biopsy; of these, 286 (37.9%) had liver steatosis.

    Existence of liver steatosis was found to be independently linked with greater body mass index (BMI), and higher serum total cholesterol and triglyceride levels.

    No significant link was found between liver steatosis and fibrosis stage (odds ratio=1.016).

    Factors independently linked with higher LSM included: age, BMI, serum gamma-glutamyl-transpeptidase, positivity for HBeAg, as well as liver fibrosis stage, and inflammation activity grade, while there was no significant link between degree of liver steatosis and LSM.

    In cases with the same histologic fibrosis stage, no significant difference in LSM values was seen among those with absent, mild, moderate, or severe steatosis.