Relationship between liver steatosis and serum virological markers during immune clearance phase of chronic hepatitis B

中华传染病杂志 Pub Date : 2018-09-15 DOI:10.3760/CMA.J.ISSN.1000-6680.2018.09.003

Jiaofeng Huang, Su Lin, Yueyong Zhu

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Abstract

Objective To investigate the relationship between hepatic steatosis and virological markers in patients with chronic hepatitis B (CHB) during immune clearance (IC) phase. Methods Pathology proven CHB patients in IC phase were collected from the Liver Center of the First Affiliated Hospital of Fujian Medical University from January 2009 to October 2016. Patients were divided into non-to mild fatty liver (F0-F1) group and moderate to severe fatty liver (F2-F4) group according to the liver steatosis degree. The relationship between liver steatosis and virological markers in serum was compared. The measurement data were analyzed using independent sample t test, and the count data were analyzed by chi-square test. Results A total of 298 patients were included, including 237 males (79.5%) and 61(20.5%) females, and the average age was (32.4±10.3) years old. The 23.5% (70/298) of these patients had liver steatosis. A total of 273 (91.6%) cases were in F0-F1 group, and the remaining 25 (8.4%) cases were in F2-F4 group. The patients in F2-F4 group had higher body mass index ([25.90±2.70] vs [21.68±2.90] kg/m2), serum triglyceride ([1.52±0.77] vs [1.11±0.55] mmol/L) and cholesterol ([4.88±1.15] vs [4.33±0.92] mmol/L) than F0-F1 group, and the differences were all statistically significant (t=-7.007, -2.667, and -2.751, respectively, all P<0.05). In addition, the serum levels of HBsAg and HBV DNA in F2-F4 group were also significantly higher than F0-F1 group (t=-3.291 and -2.831, respectivelt, both P<0.01). According to the grading of inflammation and fibrosis, the differences of HBsAg and HBV DNA levels between F0-F1 group and F2-F4 group were statistically significant only in patients with more severe inflammation (t=-2.738 and -2.135, respectively, both P<0.05) or less severe fibrosis (t=-2.258 and -2.333, respectively, both P<0.05). Conclusion Among CHB patients experiencing immune clearance, serum HBsAg and HBV DNA levels are positively correlated with the severity of hepatic steatosis, and this phenomenon is closely related to the degree of liver inflammation. Key words: Hepatitis B, chronic; Hepatitis B surface antigens; Fatty liver; Immune clearance

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慢性乙型肝炎免疫清除期肝脂肪变性与血清病毒学标志物的关系

目的探讨慢性乙型肝炎（CHB）免疫清除期肝脂肪变性与病毒学标志物的关系。方法收集福建医科大学附属第一医院肝脏中心2009年1月至2016年10月经病理证实的慢性乙型肝炎IC期患者。根据肝脂肪变性程度将患者分为非轻度脂肪肝（F0-F1）组和中度至重度脂肪肝（F2-F4）组。比较了肝脂肪变性与血清病毒学标志物的关系。测量数据采用独立样本t检验进行分析，计数数据采用卡方检验进行分析。结果298例患者，其中男性237例（79.5%），女性61例（20.5%），平均年龄（32.4±10.3）岁。23.5%（70/298）的患者有肝脂肪变性。F0-F1组共273例（91.6%），F2-F4组共25例（8.4%）。F2-F4组患者的体重指数（[25.90±2.70]vs[21.68±2.90]kg/m2）、血清甘油三酯（[1.52±0.77]vs[1.11±0.55]mmol/L）和胆固醇（[4.88±1.15]vs[4.33±0.92]mmol/L）均高于F0-F1组，差异均有统计学意义（t=-7.007、-2.667和-2.751，均P<0.05），F2-F4组血清HBsAg和HBVDNA水平也明显高于F0-F1组（t=-3.291和-2.831，均P<0.01），F0-F1组和F2-F4组HBsAg和HBVDNA水平的差异仅在炎症较重（t=-2.738和-2.135，均P<0.05）或纤维化较轻（t=-2.258和-2.333，均<0.05）的患者中具有统计学意义，血清HBsAg和HBVDNA水平与肝脂肪变性的严重程度呈正相关，这种现象与肝脏炎症程度密切相关。关键词：乙型肝炎，慢性；乙型肝炎表面抗原；脂肪肝；免疫清除

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来源期刊

中华传染病杂志

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5280

期刊介绍： The Chinese Journal of Infectious Diseases was founded in February 1983. It is an academic journal on infectious diseases supervised by the China Association for Science and Technology, sponsored by the Chinese Medical Association, and hosted by the Shanghai Medical Association. The journal targets infectious disease physicians as its main readers, taking into account physicians of other interdisciplinary disciplines, and timely reports on leading scientific research results and clinical diagnosis and treatment experience in the field of infectious diseases, as well as basic theoretical research that has a guiding role in the clinical practice of infectious diseases and is closely integrated with the actual clinical practice of infectious diseases. Columns include reviews (including editor-in-chief reviews), expert lectures, consensus and guidelines (including interpretations), monographs, short monographs, academic debates, epidemic news, international dynamics, case reports, reviews, lectures, meeting minutes, etc.