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Updated: May 21, 2026

Optimized Analysis of In Vivo and In Vitro Hepatic Steatosis
Published on: March 11, 2017
Ambient nitrogen oxides exposure associated with hepatic steatosis in patients with chronic hepatitis B
Tyng-Yuan Jang1, Yu-Ting Zeng2, Po-Cheng Liang3
1Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University and National Health Research Institutes, Taiwan; Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Center of Hepatitis Research, College of Medicine and Center of Metabolic Disorders and Obesity, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Pingtung Hospital, Ministry of Health and Welfare, Ping-Tung, Taiwan.
Background:
To investigate the association between air pollution and hepatic steatosis in patients with chronic hepatitis B.
Methods:
This cross-sectional study enrolled 1068 patients with chronic hepatitis B treated with nucleotide/nucleoside analogs from 2020 to 2023 in Kaohsiung and analyzed the incidence and risk factors for hepatic steatosis. Daily air pollutant concentrations were estimated for the year prior to enrolment.
Results:
Patients with hepatic steatosis were reported in 340 (31.8%). Patients with hepatic steatosis had higher concentrations of nitrogen oxides (NOx) compared to those without steatosis (27.8 ppb vs. 25.5 ppb; P = 0.001). Logistic regression analysis revealed that non-liver-cirrhosis was the strongest factor associated with hepatic steatosis (odds ratio (OR)/confidence interval (CI): 4.63/2.85-7.52; P < 0.001), followed by hypertriglyceridemia (OR/CI: 2.09/1.29-3.39; P < 0.001),HBeAg seropositivity (OR/CI: 1.54/1.05-2.26; P = 0.04), BMI (OR/CI: 1.10/1.06-1.14; P < 0.001) and concentrations of NOx (OR/CI: 1.018/1.004-1.033; P = 0.01). Among patients without cirrhosis, logistic regression analysis revealed that the strongest factors associated with hepatic steatosis were hypertriglyceridemia (OR/CI: 1.98/1.17-3.35; P = 0.01), followed by HBeAg seropositivity (OR/CI: 1.51/1.05-2.17; P = 0.03), BMI (OR/CI: 1.10/1.05-1.14; P < 0.001) and concentrations of NOx (OR/CI: 1.02/1.01-1.04; P = 0.01). Patients in the highest quartile of annual NOx-concentration exposure had a two-fold increased risk of hepatic steatosis compared with those in the lowest quartile (OR/CI: 2.20/1.37-3.50). Among patients with cirrhosis, logistic regression analysis revealed that the strongest factors associated with hepatic steatosis were hypertriglyceridemia (OR/CI: 3.79/1.22-11.79; P = 0.02), followed by age (OR/CI: 0.95/0.92-0.99; P = 0.02).
Conclusions:
Higher concentrations of NOx were associated with hepatic steatosis in patients with non-cirrhotic chronic hepatitis B.
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