Coincidental metabolic syndrome increases the risk of liver fibrosis progression in patients with chronic hepatitis B – a prospective cohort study with paired transient elastography examinations. Issue 8 (20th February 2014)

• Record Type: Journal Article
• Authors: Wong, G. L.‐H.; Chan, H. L.‐Y.; Yu, Z.; Chan, A. W.‐H.; Choi, P. C.‐L.; Chim, A. M.‐L.; Chan, H.‐Y.; Tse, C.‐H.; Wong, V. W.‐S.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 39:Issue 8(2014)
• Page Start: 883
• Page End: 893
• Publication Date: 2014-02-20
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.12658
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt12658-abs-0001"> <title>Summary</title> <sec id="apt12658-sec-0001" sec-type="section"> <title>Background</title> <p>Metabolic syndrome is a known risk factor of cirrhosis in chronic hepatitis B (CHB).</p> </sec> <sec id="apt12658-sec-0002" sec-type="section"> <title>Aim</title> <p>To investigate the effects of coincidental metabolic syndrome on liver fibrosis progression in treatment‐naïve CHB patients.</p> </sec> <sec id="apt12658-sec-0003" sec-type="section"> <title>Methods</title> <p>A total of 1466 CHB patients underwent liver stiffness measurement (LSM) by transient elastography in 2006–2008; 663 patients remained treatment‐naïve and had second LSM in 2010–2012. Liver fibrosis progression was defined as an increase in LSM ≥30% at the second assessment. The impact of coincidental metabolic syndrome and its factors on liver fibrosis progression were evaluated after adjustment for viral load and hepatitis activity.</p> </sec> <sec id="apt12658-sec-0004" sec-type="section"> <title>Results</title> <p>At baseline, the mean age was 43 ± 12 years, 55% were males, serum alanine aminotransferase (ALT) was 44 ± 40 IU/L, HBV DNA was 4.0 ± 2.0 log IU/mL and LSM was 6.3 ± 3.6 kPa. Metabolic syndrome was diagnosed in 80 (12%) and 142 (21%) patients at baseline and follow‐up visit, respectively; 84 (13%) and 22 (3%) patients had coincidental and resolved metabolic syndrome respectively. After an interval of 44 ± 7 months, 107 (16%) patients developed liver fibrosis progression. Coincidental metabolic syndrome [adjusted odds ratio (aOR) 2.0, 95% confidence interval (CI) 1.1–3.5, <italic>P </italic>=<italic> </italic>0.015], central obesity (aOR 2.0, 95% CI 1.0–4.1, <italic>P </italic>=<italic> </italic>0.05) and low level of high‐density lipoprotein cholesterol (aOR 1.9, 95% CI 1.0–3.7, <italic>P </italic>=<italic> </italic>0.04) were associated with liver fibrosis progression independent of change in viral load and ALT level. The effects of coincidental metabolic syndrome were most apparent in the immune‐tolerant phase.</p> </sec> <sec id="apt12658-sec-0005" sec-type="section"> <title>Conclusion</title> <p>Coincidental metabolic syndrome increases the risk of liver fibrosis progression in patients with chronic hepatitis B infection, independent of viral load and hepatitis activity.</p> </sec> </abstract>