Prevalence and risk factors of hepatic steatosis and its impact on liver injury in Chinese patients with chronic hepatitis B infection.
OBJECTIVE
The clinical significance of hepatic steatosis in chronic hepatitis B infection (CHB) is unclear. The aims of this study were thus to investigate the prevalence and risk factors for hepatic steatosis in patients with CHB and its relationship with liver injury.


METHODS
Consecutive patients with biopsy-proven CHB at Hangzhou Sixth People's Hospital between January 2005 and June 2007 were included. Patients co-infected with other viruses or suffering from liver disease of any other cause were excluded. Liver steatosis, necroinflammation and fibrosis were assessed by both Brunt and Scheuer classifications.


RESULTS
A total of 1915 patients (1497 men) with a mean age of 31 +/- 9.5 years were analyzed. Hepatic steatosis was present in 260 (14%) patients. The steatosis involved < 33% of hepatocytes in 90% of cases, and was more frequent among men than women (15% vs 8%, P < 0.001). Two-thirds (178 of 260) of patients with steatosis were hepatitis B e antigen (HBeAg)-positive, but there was no correlation with either serum HBeAg status or hepatitis B virus DNA titer. Degree of inflammation and fibrosis were more mild among those with steatosis than those without. Multivariate analysis showed that steatosis was independently associated with body mass index, serum triglyceride, apolipoprotein B, uric acid, and fasting blood glucose. However, fibrosis was only independently associated with age and inflammatory grade, and the latter associated with viral load and fibrosis stage.


CONCLUSIONS
Hepatic steatosis is common in CHB, it is associated with metabolic factors not viral ones, and does not appear to affect the severity of liver disease.
Center for Fatty Liver Disease, Shanghai First People's Hospital, Jiaotong University, Shanghai, China.
Jun-ping
JP
Shi
Jian-gao
JG
Fan
Rui
R
Wu
Xiao-qian
XQ
Gao
Li
L
Zhang
Hao
H
Wang
Geoffrey C
GC
Farrell
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data; D002648:Child; D002681:China / Q000453:epidemiology; D005234:Fatty Liver / Q000208:ethnology / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000821:virology; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000208:ethnology / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology* / Q000821:virology; D008103:Liver Cirrhosis / Q000208:ethnology / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult