Hepatic steatosis and metabolic risk factors among patients with chronic hepatitis B: The multicentre, prospective CAP‐Asia study

Abstract

We aimed to compare the severity of liver disease, metabolic profile and cardiovascular disease (CVD) risk of chronic hepatitis B (CHB) patients with and without hepatic steatosis and patients with non-alcoholic fatty liver disease (NAFLD). Patients with NAFLD and CHB were prospectively enrolled from 10 Asian centres. Fibroscan was performed for all patients and hepatic steatosis was defined based on controlled attenuation parameter >248 dB/m. CVD risk was assessed using the Framingham risk score. The data for 1080 patients were analysed (67% NAFLD, 33% CHB). A high proportion (59%) of CHB patients had hepatic steatosis. There was a significant stepwise increase in alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, controlled attenuation parameter and liver stiffness measurement, from CHB patients without hepatic steatosis to CHB patients with hepatic steatosis to NAFLD patients (p < 0.001 for all comparisons). There was a significant stepwise increase in the proportion of patients with metabolic syndrome and in CVD risk, with very high or extreme CVD risk seen in 20%, 48% and 61%, across the groups (p < 0.001 between CHB patients with and without hepatic steatosis and p < 0.05 between CHB patients with hepatic steatosis and NAFLD patients). In conclusion,

Long-term clinical outcomes of adults with metabolic dysfunction-associated fatty liver disease: a single-centre prospective cohort study with baseline liver biopsy

“…Asians are known to develop metabolic complications at lower BMI than their Caucasian counterparts [ 39 ]. Besides that, a retrospective study and a subsequent prospective study in several Asian centres found high rates of suboptimal treatment of metabolic risk factors among patients with NAFLD [ 40 , 41 ].…”

Potential impact of Helicobacter pylori infection on hepatic steatosis and metabolic risk factors among patients with chronic hepatitis B

“…To the Editor, Leow et al 1 concluded that chronic hepatitis B (CHB) patients with liver steatosis and metabolic syndrome (MetS) exhibit, beyond a more severe liver disease, a higher risk of MetS-related severe complications including cardiovascular disease (CVD). Additional data also indicate that, hepatitis B virus (HBV)-induced inflammatory reactions and molecular pathways could represent an aggravating component in hepatic steatosis development; and HBV with MetSrelated fatty liver disease displays a high risk of liver fibrosis and long-term mortality.…”

“…Apostolis Papaefthymiou 1,2,3 Stergios A. Polyzos 3 Evangelos Kazakos 1,4 Dimitrios Tzilves 5 Georgia Lazaraki 5…”

Response to letter to editor: Potential impact of Helicobacter pylori infection on hepatic steatosis and metabolic risk factors among patients with chronic hepatitis B

“…4 Our study has found that CHB patients with hepatic steatosis had worse metabolic profile, higher cardiovascular disease risk and more severe liver disease. 5 As part of an ongoing prospective study, continuous assessment of anthropometry, lifestyle habits, metabolic risk factors, liver and cardiovascular outcome is being carried out and the results are awaited. Although data on Hp-I status were not collected, we agree that Hp-I may be an important factor and further studies are warranted to elucidate this matter.…”