Maria Kalafateli, Roberta Forlano, Eleanor Barnes, Laura Martinez-Gili, Madeleine Lacey, Giordano Sigon, Benjamin H Mullish, Vincent Mallet, Lucia Parlati, Paul Richardson, Niamh Forde, Gaetano Serviddio, Rosanna Villani, Sabela Lens, Maria Buti, Elena Vargas, Mauro Viganò, Alessandro Loglio, Pietro Lampertico, Roberta D'ambrosio, Sara Monico, Gabriele Maffi, Rosa Lombardi, Anna Ludovica Fracanzani, Chiara De Luca, Patrick Ingiliz, Alessandra Mangia, Federica Leserre, Antonio Manuel Napolitano, Valeria Piazzolla, Francesco Paolo Russo, Giovanni Raimondo, Irene Cacciola, Carlo Saitta, Maud Lemoine, George Papatheodoridis, Margarita Papatheodoridi, Dimitrios N Samonakis, Denise O'Donnell, Jennifer O'Donoghue, Robin Daniel Abeles, Nicola Pugliese, Alessio Aghemo, Marina Berenguer, Ashley Brown, Mark R Thursz, Pinelopi Manousou
{"title":"Risk Factors of Metabolic Dysfunction-associated Steatotic Liver Disease in a Cohort of Patients With Chronic Hepatitis B.","authors":"Maria Kalafateli, Roberta Forlano, Eleanor Barnes, Laura Martinez-Gili, Madeleine Lacey, Giordano Sigon, Benjamin H Mullish, Vincent Mallet, Lucia Parlati, Paul Richardson, Niamh Forde, Gaetano Serviddio, Rosanna Villani, Sabela Lens, Maria Buti, Elena Vargas, Mauro Viganò, Alessandro Loglio, Pietro Lampertico, Roberta D'ambrosio, Sara Monico, Gabriele Maffi, Rosa Lombardi, Anna Ludovica Fracanzani, Chiara De Luca, Patrick Ingiliz, Alessandra Mangia, Federica Leserre, Antonio Manuel Napolitano, Valeria Piazzolla, Francesco Paolo Russo, Giovanni Raimondo, Irene Cacciola, Carlo Saitta, Maud Lemoine, George Papatheodoridis, Margarita Papatheodoridi, Dimitrios N Samonakis, Denise O'Donnell, Jennifer O'Donoghue, Robin Daniel Abeles, Nicola Pugliese, Alessio Aghemo, Marina Berenguer, Ashley Brown, Mark R Thursz, Pinelopi Manousou","doi":"10.1016/j.cgh.2025.06.014","DOIUrl":null,"url":null,"abstract":"<p><strong>Background & aims: </strong>Chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD) commonly co-exist, with conflicting data in prevalence and disease severity. We aimed to investigate these discrepancies.</p><p><strong>Methods: </strong>This multicenter study included consecutive patients with CHB from 19 European centers. A survey on standard of care for MASLD screening in CHB was circulated.</p><p><strong>Results: </strong>A total of 1709 patients with CHB were included; median age, 53 years (interquartile range [IQR], 42-64); males, 60.7%; body mass index (BMI), 25.6 kg/m<sup>2</sup> (IQR, 14-63 kg/m<sup>2</sup>); and 57.3% White. MASLD prevalence (1510 consecutive patients) was 42.3%. BMI (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.19-1.36), ferritin (OR, 1.00; 95% CI, 1.00-1.00) and type 2 diabetes (OR, 2.60; 95% CI, 1.12-6.02) were independently associated with MASLD. The prevalence of advanced fibrosis was 18% (255/1420) in the whole cohort, 25.4% (162/639) among patients with CHB with MASLD, and 13.7% in those without MASLD. Independent predictors of advanced fibrosis were MASLD (OR, 2.76; 95% CI, 1.50-5.05), BMI (OR, 1.08; 95% CI, 1.02-1.15), alanine transaminase (OR, 1.01; 95% CI, 1.00-1.03), lower platelets (OR, 0.99; 95% CI, 0.98-0.99), insulin treatment (OR, 13.88; 95% CI, 2.95-65.28), and long-term antivirals (OR, 4.86; 95% CI, 2.40-9.85). During follow-up (48 months), only patients without MASLD showed significant liver stiffness measurement improvement over time (P < .001). Among patients with MASLD, Fibrosis-4 and liver stiffness measurement performed moderately at predicting advanced fibrosis (area under the receiver operating characteristic curve = 0.71 vs 0.70; P = .38) against histology. As standard of care, 68.4% of centers screened all patients with CHB for MASLD; 52.6% followed the same treatment indication in those with CHB and MASLD vs CHB only.</p><p><strong>Conclusion: </strong>In this large European cohort, MASLD and fibrosis were highly prevalent among patients with CHB, whereas MASLD aggravated liver fibrosis. Though screening strategies remain inconsistent, ferritin levels, increased BMI, and type 2 diabetes may inform on the presence of MASLD. Biomarkers showed modest performance in predicting fibrosis.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0000,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Gastroenterology and Hepatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.cgh.2025.06.014","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background & aims: Chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD) commonly co-exist, with conflicting data in prevalence and disease severity. We aimed to investigate these discrepancies.
Methods: This multicenter study included consecutive patients with CHB from 19 European centers. A survey on standard of care for MASLD screening in CHB was circulated.
Results: A total of 1709 patients with CHB were included; median age, 53 years (interquartile range [IQR], 42-64); males, 60.7%; body mass index (BMI), 25.6 kg/m2 (IQR, 14-63 kg/m2); and 57.3% White. MASLD prevalence (1510 consecutive patients) was 42.3%. BMI (odds ratio [OR], 1.27; 95% confidence interval [CI], 1.19-1.36), ferritin (OR, 1.00; 95% CI, 1.00-1.00) and type 2 diabetes (OR, 2.60; 95% CI, 1.12-6.02) were independently associated with MASLD. The prevalence of advanced fibrosis was 18% (255/1420) in the whole cohort, 25.4% (162/639) among patients with CHB with MASLD, and 13.7% in those without MASLD. Independent predictors of advanced fibrosis were MASLD (OR, 2.76; 95% CI, 1.50-5.05), BMI (OR, 1.08; 95% CI, 1.02-1.15), alanine transaminase (OR, 1.01; 95% CI, 1.00-1.03), lower platelets (OR, 0.99; 95% CI, 0.98-0.99), insulin treatment (OR, 13.88; 95% CI, 2.95-65.28), and long-term antivirals (OR, 4.86; 95% CI, 2.40-9.85). During follow-up (48 months), only patients without MASLD showed significant liver stiffness measurement improvement over time (P < .001). Among patients with MASLD, Fibrosis-4 and liver stiffness measurement performed moderately at predicting advanced fibrosis (area under the receiver operating characteristic curve = 0.71 vs 0.70; P = .38) against histology. As standard of care, 68.4% of centers screened all patients with CHB for MASLD; 52.6% followed the same treatment indication in those with CHB and MASLD vs CHB only.
Conclusion: In this large European cohort, MASLD and fibrosis were highly prevalent among patients with CHB, whereas MASLD aggravated liver fibrosis. Though screening strategies remain inconsistent, ferritin levels, increased BMI, and type 2 diabetes may inform on the presence of MASLD. Biomarkers showed modest performance in predicting fibrosis.
期刊介绍:
Clinical Gastroenterology and Hepatology (CGH) is dedicated to offering readers a comprehensive exploration of themes in clinical gastroenterology and hepatology. Encompassing diagnostic, endoscopic, interventional, and therapeutic advances, the journal covers areas such as cancer, inflammatory diseases, functional gastrointestinal disorders, nutrition, absorption, and secretion.
As a peer-reviewed publication, CGH features original articles and scholarly reviews, ensuring immediate relevance to the practice of gastroenterology and hepatology. Beyond peer-reviewed content, the journal includes invited key reviews and articles on endoscopy/practice-based technology, health-care policy, and practice management. Multimedia elements, including images, video abstracts, and podcasts, enhance the reader's experience. CGH remains actively engaged with its audience through updates and commentary shared via platforms such as Facebook and Twitter.