title: Sonographic fatty liver and hepatitis B virus carrier status: synergistic effect on liver damage in Taiwanese adults.
abstract: OBJECTIVE
  To examine the epidemiology of hepatitis B virus carrier status (HBVC) and sonographic fatty liver (SFL) in Taiwanese adults, and to evaluate their possible interaction in inducing liver damage (LD). >From an epidemiological viewpoint, we analyzed previous studies which indicated that fatty liver sensitizes host immune response to HBV infection and enhances liver damage.
  
  
  METHODS
  A cross-sectional retrospective analysis of health records including medical history, physical examination, abdominal sonogram, blood biochemistry and hepatic virological tests. We utilized the Student's t-test, chi-square, multivariate logistic regression and synergy index to assess risks for LD.
  
  
  RESULTS
  Among a total of 5406 Taiwanese adults (mean age 46.2 years, 51.5% males), the prevalence of LD, HBVC and SFL were 12.3%, 15.1% and 33.4%, respectively; 5.1% of participants had SFL plus HBVC. Multivariate logistic regression analysis demonstrated that male gender (odds ratio (OR) = 2.8, 95% confidence interval (CI): 2.3-3.5), overweight state (OR = 1.6, 95% CI: 1.3-2.0), HBVC (OR = 2.5, 95% CI: 2.0-3.1) and SFL (OR = 4.2, 95% CI: 2.2-5.3) were independently associated with LD. Synergism analysis showed that the adjusted OR for LD in adults with HBVC-alone was 3.3 (95% CI: 2.4-4.6), SFL-alone, 4.7 (95% CI: 3.7-6.1) and combined HBVC and SFL, 9.5 (95% CI: 6.8-13.3); the synergy index was 1.4 (95% CI: 1.001-2.0).
  
  
  CONCLUSIONS
  In Taiwanese adults, SFL plus HBVC have a significant synergistic association with LD.
authors.affiliation: Department of Family Medicine and Center for Environmental and Occupational Medicine, Shin Kong Wu Ho-Su Memorial Hospital, 95, Wen Chang Road, Shih Lin, Taipei 111, Taiwan, China.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Lin
authors.forename: Shu-Tin
authors.initials: ST
authors.lastname: Hsiao
authors.forename: Jong-Dar
authors.initials: JD
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D002353:Carrier State / Q000473:pathology*; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006306:Health Surveys; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology / Q000208:ethnology / Q000517:prevention & control; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D006515:Hepatitis B virus; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000473:pathology / Q000821:virology; D008107:Liver Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D014463:Ultrasonography
chemical_list: D017325:Hepatitis B Vaccines; D000410:Alanine Transaminase