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Concomitant Diseases and Co-contribution on Progression of Liver Stiffness in Patients with Hepatitis B Virus
Chang-Hai Liu1,2, Wei Jiang1,2, Dong-Bo Wu1,2
1Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China.
Insights
Hepatitis B (HBV) infection is linked to lower risks of fatty liver and metabolic syndrome but higher risks of type 2 diabetes (T2DM) and H. pylori infection. T2DM may worsen liver issues in HBV patients.
Area of Science:
- Hepatology
- Infectious Diseases
- Metabolic Disorders
Background:
- The interplay between Hepatitis B virus (HBV) infection and common comorbidities like fatty liver, type 2 diabetes mellitus (T2DM), metabolic syndrome (MetS), and Helicobacter pylori (Hp) infection is not well understood.
- Clarifying these associations is crucial for comprehensive patient management.
Purpose of the Study:
- To investigate the associations between Hepatitis B surface antigen (HBsAg) positivity and the prevalence of fatty liver, T2DM, MetS, and Hp infection.
- To explore the co-contribution of HBV and T2DM to abnormal liver transaminase levels and liver stiffness progression.
Main Methods:
- Analysis of HBsAg screening data from 95,998 participants at West China Hospital (2014-2017).
- Utilized multivariable logistic regression to calculate adjusted odds ratios for various associations.
Main Results:
- HBsAg positivity was associated with a decreased risk of fatty liver (OR 0.71) and MetS (OR 0.74), but an increased risk of Hp infection (OR 1.09) and T2DM (OR 1.18).
- HBsAg-positive patients with T2DM exhibited significantly higher risks of elevated ALT and AST compared to HBV-alone patients.
- T2DM, in conjunction with HBV, was also linked to increased risks of liver fibrosis (OR 3.23) and cirrhosis (OR 4.31).
Conclusions:
- Hepatitis B patients demonstrate a reduced likelihood of fatty liver and metabolic syndrome but an elevated risk for T2DM and Hp infection.
- Type 2 diabetes mellitus may be a significant contributing factor to abnormal liver enzyme levels and the progression of liver fibrosis in HBsAg-positive individuals.
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.
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