Hepatitis B virus infection and risk of non-alcoholic fatty liver disease: A population-based cohort study.
Adult
Age Distribution
Body Mass Index
China
/ epidemiology
Comorbidity
Diabetes Mellitus, Type 2
/ epidemiology
Female
Follow-Up Studies
Hepatitis B, Chronic
/ epidemiology
Humans
Incidence
Male
Middle Aged
Multivariate Analysis
Non-alcoholic Fatty Liver Disease
/ epidemiology
Obesity
/ epidemiology
Overweight
/ epidemiology
Proportional Hazards Models
Risk Factors
Sex Distribution
BMI
NAFLD
HBsAg carriers
diabetes mellitus
Journal
Liver international : official journal of the International Association for the Study of the Liver
ISSN: 1478-3231
Titre abrégé: Liver Int
Pays: United States
ID NLM: 101160857
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
20
12
2017
revised:
19
06
2018
accepted:
03
07
2018
pubmed:
20
7
2018
medline:
9
1
2020
entrez:
20
7
2018
Statut:
ppublish
Résumé
Although non-alcoholic fatty liver disease (NAFLD) has been studied extensively, the potential risk factors for NAFLD among chronic hepatitis B (CHB) patients have not been fully known. A population-based cohort of adult CHB patients without a history of alcohol drinking or NAFLD were recruited and followed up from October 2012 to January 2015 in Jiangsu province, China. Using Cox proportional hazards regression model, potential risk factors including viral and metabolic factors for NAFLD were evaluated. Two thousand three hundred and ninety-three adult CHB patients (mean age 50.7 ± 13.2 years) were included in the cohort. With 4429 person-years of follow-up, 283 individuals progressed to NAFLD with an incidence rate of 63.89/1000 person-years. Overweight and obese CHB patients had an increased risk of NAFLD (overweight adjusted hazard ratio [HR], 3.10; 95% CI, 2.29-4.18; obese HR, 8.52; 95%CI, 5.93-12.25) compared to normal weight carriers. The incidence of NAFLD was associated with concurrent type 2 diabetes mellitus (DM) (HR, 1.88; 95%CI, 1.15-3.08). However, no associations between viral factors with NAFLD incidence rate were identified. In a subgroup of participants with concurrent type 2 DM, detectable HBV DNA levels were negatively associated with the development of NAFLD (HR, 0.37; 95%CI, 0.14-0.98). There was super-multiplicative interaction between BMI and gender with respect to incidence of NAFLD, with an ROR of 2.08 (95%CI, 1.02-4.23). Metabolic factors play an important role in the presence of NAFLD among Chinese CHB patients. However, viral replication factors are not related to NAFLD except among those with concurrent type 2 DM.
Sections du résumé
BACKGROUND & AIMS
Although non-alcoholic fatty liver disease (NAFLD) has been studied extensively, the potential risk factors for NAFLD among chronic hepatitis B (CHB) patients have not been fully known.
METHODS
A population-based cohort of adult CHB patients without a history of alcohol drinking or NAFLD were recruited and followed up from October 2012 to January 2015 in Jiangsu province, China. Using Cox proportional hazards regression model, potential risk factors including viral and metabolic factors for NAFLD were evaluated.
RESULTS
Two thousand three hundred and ninety-three adult CHB patients (mean age 50.7 ± 13.2 years) were included in the cohort. With 4429 person-years of follow-up, 283 individuals progressed to NAFLD with an incidence rate of 63.89/1000 person-years. Overweight and obese CHB patients had an increased risk of NAFLD (overweight adjusted hazard ratio [HR], 3.10; 95% CI, 2.29-4.18; obese HR, 8.52; 95%CI, 5.93-12.25) compared to normal weight carriers. The incidence of NAFLD was associated with concurrent type 2 diabetes mellitus (DM) (HR, 1.88; 95%CI, 1.15-3.08). However, no associations between viral factors with NAFLD incidence rate were identified. In a subgroup of participants with concurrent type 2 DM, detectable HBV DNA levels were negatively associated with the development of NAFLD (HR, 0.37; 95%CI, 0.14-0.98). There was super-multiplicative interaction between BMI and gender with respect to incidence of NAFLD, with an ROR of 2.08 (95%CI, 1.02-4.23).
CONCLUSION
Metabolic factors play an important role in the presence of NAFLD among Chinese CHB patients. However, viral replication factors are not related to NAFLD except among those with concurrent type 2 DM.
Identifiants
pubmed: 30025200
doi: 10.1111/liv.13933
pmc: PMC6309470
mid: NIHMS984165
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
70-80Subventions
Organisme : NCI NIH HHS
ID : T32 CA009142
Pays : United States
Organisme : NIEHS NIH HHS
ID : R21 ES011667
Pays : United States
Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
PLoS One. 2014 Jun 30;9(6):e101501
pubmed: 24979048
Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Nov 10;37(11):1463-1467
pubmed: 28057135
PLoS One. 2013 Aug 22;8(8):e72049
pubmed: 23991037
J Hepatol. 2007 Aug;47(2):239-44
pubmed: 17400323
Gastroenterology. 2007 May;132(5):1955-67
pubmed: 17484888
Hepatology. 2015 Dec;62(6):1723-30
pubmed: 26274335
J Hepatol. 2012 Mar;56(3):533-40
pubmed: 22027575
J Gastroenterol Hepatol. 2011 Sep;26(9):1361-7
pubmed: 21649726
Dig Dis Sci. 2014 Oct;59(10):2571-9
pubmed: 24838496
J Virol. 2015 Dec 04;90(4):1729-40
pubmed: 26637457
J Clin Oncol. 2008 Dec 1;26(34):5576-82
pubmed: 18955457
Vaccine. 2009 Nov 5;27(47):6550-7
pubmed: 19729084
Oncotarget. 2017 Nov 3;8(63):107295-107302
pubmed: 29291029
Hepatology. 2017 Mar;65(3):828-835
pubmed: 28035771
Am J Gastroenterol. 2006 Jan;101(1):76-82
pubmed: 16405537
J Gastroenterol Hepatol. 2008 May;23(5):779-82
pubmed: 18028349
Hepatology. 2016 Jul;64(1):73-84
pubmed: 26707365
Dig Dis. 2010;28(1):155-61
pubmed: 20460905
Eur J Intern Med. 2015 Jan;26(1):30-6
pubmed: 25553983
Eur J Gastroenterol Hepatol. 2009 May;21(5):512-6
pubmed: 19190500
J Gastroenterol Hepatol. 2017 Mar;32(3):667-676
pubmed: 27547913
Liver Int. 2017 Apr;37(4):542-551
pubmed: 27740738
Liver Int. 2007 Jun;27(5):607-11
pubmed: 17498244
Medicine (Baltimore). 2016 Apr;95(17):e3565
pubmed: 27124068
J Viral Hepat. 2018 Jan;25(1):97-104
pubmed: 28772340
Gastroenterology. 2017 Oct;153(4):1006-1017.e5
pubmed: 28711626
Dig Dis Sci. 2015 Dec;60(12):3513-24
pubmed: 26112990
Am J Epidemiol. 1997 Jun 1;145(11):1039-47
pubmed: 9169913
Liver Int. 2018 May;38(5):803-812
pubmed: 28898508