乙型肝炎病毒感染患者肝硬化进展的伴发疾病及共同作用

StephenW

乙型肝炎病毒感染患者肝硬化进展的伴发疾病及共同作用
刘长海 1 2 , 魏江 1 2 , 吴东波 1 2 , 曾庆民 1 2 , 王友娟 3 , 唐红 4 5
隶属关系
隶属关系

    1
    【作者单位】： 四川大学华西医院感染病中心;
    2
    四川大学华西医院生物治疗国家重点实验室传染病中心传染病科，四川省成都市国学巷37号，610041
    3
    【作者单位】： 四川大学华西医院健康管理中心;
    4
    【作者单位】： 四川大学华西医院感染病中心; [email protected]。
    5
    四川大学华西医院生物治疗国家重点实验室传染病中心传染病科，四川省成都市国学巷37号，610041 [email protected]。

    PMID：36227429 DOI：10.1007/s10620-022-07695-2

抽象的

背景：乙型肝炎与伴随疾病（如脂肪肝、T2DM、MetS 和 Hp 感染）之间的关联仍不清楚。

目的：本研究旨在阐明转氨酶异常与肝脏僵硬进展之间的关联并探讨其共同作用。

方法：2014年至2017年在华西医院共有95998名参与者接受了HBsAg筛查。采用多变量逻辑回归确定调整后的比值比。

结果：在我们纳入的研究人群中，HBsAg 阳性率为 8.30%。 HBsAg 阳性与脂肪肝的负风险相关（优势比 [OR] 0.71, 95% 置信区间 [CI] 0.65-0.78, p < 0.001）和 MetS (OR 0.74, 95% CI 0.67-0.84, p < 0.001) , 并且具有 Hp 感染 (OR 1.09, 95% CI 1.02-1.17, p = 0.012) 和 T2DM (OR 1.18, 95% CI 1.01-1.40, p = 0.043) 的阳性风险。此外，HBsAg 阳性的 T2DM 患者 ALT 升高的风险更高（OR 2.09, 95% CI 1.69-2.83, p < 0.001 vs OR 1.59, 95% CI 1.51-1.68, p < 0.001），AST（OR 2.69, 95 % CI 1.98-3.65, p < 0.001 vs OR 1.89, 95% CI 1.76-2.02, p < 0.001) 比单独使用 HBV。除了 HBV，T2DM 还可以增加肝纤维化（OR 3.23，95% CI 1.35-7.71，p = 0.008）和肝硬化（OR 4.31，95% CI 1.41-13.20，p = 0.010）的风险。

结论：乙型肝炎患者发生脂肪肝和MetS的风险较低，T2DM和Hp感染的风险较高。此外，T2DM 可能与 HBsAg 阳性患者的肝转氨酶异常和纤维化进展有关。

关键词：肝转氨酶异常；并存的疾病；乙肝病毒；肝脏僵硬;代谢综合征;多变量逻辑回归； 2型糖尿病。

© 2022。作者获得 Springer Science+Business Media, LLC 的独家许可，该公司隶属于 Springer Nature。

StephenW

Concomitant Diseases and Co-contribution on Progression of Liver Stiffness in Patients with Hepatitis B Virus Infection
Chang-Hai Liu  1   2 , Wei Jiang  1   2 , Dong-Bo Wu  1   2 , Qing-Min Zeng  1   2 , You-Juan Wang  3 , Hong Tang  4   5
Affiliations
Affiliations

    1
    Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China.
    2
    Division of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Disease, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
    3
    Health Management Center, West China Hospital of Sichuan University, Chengdu, China.
    4
    Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China. [email protected].
    5
    Division of Infectious Diseases, State Key Laboratory of Biotherapy and Center of Infectious Disease, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. [email protected].

    PMID: 36227429 DOI: 10.1007/s10620-022-07695-2

Abstract

Background: The association between hepatitis B and concomitant diseases, such as fatty liver, T2DM, MetS, and Hp infection, remains unclear.

Aim: The present study was to illustrate the association and explore the co-contribution on abnormal transaminase and progression of liver stiffness.

Methods: A total of 95,998 participants underwent HBsAg screening in West China Hospital from 2014 to 2017. Multivariable logistic regression was used to determine the adjusted odds ratios.

Results: The prevalence of HBsAg-positive rate was 8.30% of our included study population. HBsAg positive was associated with negative risk of fatty liver (odds ratio [OR] 0.71, 95% confidence interval [CI] 0.65-0.78, p < 0.001) and MetS (OR 0.74, 95% CI 0.67-0.84, p < 0.001), and with positive risk of Hp infection (OR 1.09, 95% CI 1.02-1.17, p = 0.012) and T2DM (OR 1.18, 95% CI 1.01-1.40, p = 0.043). Besides, HBsAg-positive patients with T2DM had higher risk of elevated ALT (OR 2.09, 95% CI 1.69-2.83, p < 0.001 vs OR 1.59, 95% CI 1.51-1.68, p < 0.001), AST (OR 2.69, 95% CI 1.98-3.65, p < 0.001 vs OR 1.89, 95% CI 1.76-2.02, p < 0.001) than HBV alone. In addition to HBV, T2DM also can increase the risk of liver fibrosis (OR 3.23, 95% CI 1.35-7.71, p = 0.008) and cirrhosis (OR 4.31, 95% CI 1.41-13.20, p = 0.010).

Conclusion: Hepatitis B patients have a lower risk of fatty liver and MetS, and a higher risk of T2DM and Hp infection. Besides, T2DM might be possibly associated with abnormal liver transaminase and fibrosis progression in HBsAg-positive patients.

Keywords: Abnormal liver transaminase; Coexisting diseases; HBV; Liver stiffness; Metabolic syndrome; Multivariable logistic regression; Type 2 diabetes mellitus.

© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.