期刊
AMERICAN JOURNAL OF GASTROENTEROLOGY
卷 116, 期 8, 页码 1686-1697出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.14309/ajg.0000000000001257
关键词
-
资金
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [U01-DK082843, U01-DK082863, U01-DK082864, U01-DK082866, U01-DK082867, U01-DK082871, U01-DK082872, U01-DK082874, U01-DK082919, U01-DK082923, U01-DK082927, U01-DK082943, U01-DK082944, U01-DK082916]
- Immunology Center (NIH/NIDDK Center of Molecular Studies in Digestive and Liver Diseases) [P30DK50306]
- NIH Public Health Service Research Grant [M01-RR00040]
- NCATS [National Center for Advancing Translational Sciences, NIH] [UL1TR000058]
- CTSA [UL1TR000004, UL1TR001111, UL1RR024986, U54TR001959, UL1TR000423]
- Gilead Sciences
- Roche Molecular Systems via a CRADA through the NIDDK
- NIDDK [A-DK-3002-001]
- NIDDK, NIH
- NCI, NIH
- [K24AA022523]
In a large North American cohort of chronic hepatitis B patients, nearly a third had fatty liver disease, with 13% having steatohepatitis. Steatohepatitis was associated with advanced fibrosis and increased hepatic inflammation markers over time, highlighting the importance of screening and managing metabolic abnormalities to prevent disease progression in HBV patients.
INTRODUCTION: Fatty liver disease (FLD) influences liver disease progression and liver cancer risk. We investigated the impact of FLD on liver disease severity in a large North American cohort with chronic hepatitis B virus (HBV). METHODS: Liver biopsies from 420 hepatitis B surface antigen-positive adults enrolled in the Hepatitis B Research Network and who were not on HBV therapy in the previous month were evaluated for inflammation and fibrosis. Steatohepatitis was based on steatosis, hepatocyte ballooning +/- Mallory-Denk bodies, and perisinusoidal fibrosis. Models evaluated factors associated with steatohepatitis, and the associations of steatohepatitis with fibrosis, and longitudinal alanine aminotransferase, aspartate aminotransferase, and Fibrosis-4. RESULTS: The median age was 42 years, 62.5% were male, and 79.5% were Asian. One hundred thirty-two (31.4%) patients had FLD (77 [18.3%] steatosis only, 55 [13.1%] steatohepatitis). Older age, overweight/obesity, and diabetes were associated with steatohepatitis. Steatohepatitis (vs no FLD) was associated with 1.68 times higher risk of advanced fibrosis at baseline (95% confidence interval, 1.12-2.51), and there was an indication of higher incident cirrhosis rate during follow-up. Steatohepatitis vs no FLD was also independently associated with, on average, 1.39 times higher alanine aminotransferase (P < 0.01) and 1.25 times higher Fibrosis-4 (P = 0.04) across 4 years. DISCUSSION: Coexisting steatosis occurred in nearly a third of adults (13% had steatohepatitis) with chronic HBV in this North American cohort who underwent liver biopsies. Steatohepatitis was associated with advanced fibrosis and higher biochemical measures of hepatic inflammation over time. Therefore, in addition to viral suppression, screening for and managing metabolic abnormalities is important to prevent disease progression in HBV.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据