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Pre-Existing and New-Onset Metabolic Dysfunctions Increase Cirrhosis and Its Complication Risks in Chronic Hepatitis
Shang-Chin Huang1,2,3,4, Tung-Hung Su2,3, Tai-Chung Tseng3,5
1Department of Internal Medicine, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan.
The American Journal of Gastroenterology
|June 26, 2024
Summary
Metabolic dysfunction (MD) significantly increases cirrhosis and complication risks in chronic hepatitis B (CHB) patients. Early detection of metabolic comorbidities in CHB is crucial for managing liver disease progression.
Area of Science:
- Hepatology
- Metabolic Diseases
- Virology
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence is rising in chronic hepatitis B (CHB) patients.
- Understanding the impact of metabolic dysfunction (MD) on liver disease progression in CHB is critical.
Purpose of the Study:
- To investigate the association between metabolic dysfunction (MD) and the risk of cirrhosis and its complications in patients with chronic hepatitis B (CHB).
Main Methods:
- A cohort of 11,502 treatment-naive CHB patients were followed for a median of 5.3 years.
- Metabolic dysfunction (MD) was defined using 5 cardiometabolic criteria from the MASLD definition.
- Patients were categorized into MD and non-MD groups for risk analysis.
Main Results:
- MD patients had significantly higher risks of cirrhosis (aHR: 1.82) and cirrhotic complications (aHR: 1.30), showing a dose-dependent relationship.
- New-onset diabetes mellitus exacerbated the risk of cirrhotic complications (aHR: 2.87).
- Hepatic steatosis was associated with lower risks of cirrhosis and complications, but MASLD patients with steatosis still had higher cirrhosis risk than non-MD patients.
Conclusions:
- Concurrent and new-onset metabolic dysfunction (MD) independently elevate risks for cirrhosis and complications in CHB patients, irrespective of hepatic steatosis.
- Proactive screening for metabolic comorbidities in CHB patients is essential for accurate liver disease risk stratification.
- This research highlights the critical interplay between metabolic health and viral hepatitis in liver disease progression.
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