title: Inverse association between hepatitis B virus infection and fatty liver disease: a large-scale study in populations seeking for check-up.
abstract: BACKGROUND
  Although many studies have attempted to clarify the association between hepatitis B virus (HBV) infection and fatty liver disease, no prior studies have emphasized the relationship of HBV and fatty liver regarding different demographics of age and body mass index (BMI).
  
  
  OBJECTIVE
  To investigate the correlation of HBV and fatty liver in the different demographics of age and BMI.
  
  
  METHODS
  We enrolled consecutive subjects who had received health check-up services at the Taipei Veterans General Hospital from 2002 to 2009 and ultrasonography was used to diagnose fatty liver according to the practice guidelines of the American Gastroenterological Association.
  
  
  RESULTS
  Among the 33,439 subjects enrolled in this study, fatty liver was diagnosed in 43.9% of the population and 38.9% of patients with chronic HBV infection. Multivariate analysis showed that BMI, age, waist circumference, systolic blood pressure, fasting glucose, cholesterol, alanine aminotransferase (ALT) levels, and platelet counts were positively associated, while hepatitis B surface antigen (HBsAg) positivity was inversely associated with fatty liver, especially for subjects with BMI>22.4 kg/m(2) and age>50 years. On the contrary, HBV infection was positively correlated with the presence of elevated serum ALT levels in subjects with fatty liver disease regardless of their age and BMI.
  
  
  CONCLUSIONS
  Metabolic factors are important determinants for the prevalence of fatty liver. Patients with HBV infection were inversely associated with fatty liver disease than the general population, especially in older and obese patients. Furthermore, metabolic factors and HBV infection were associated with elevated serum ALT levels in fatty liver disease.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Yuan-Lung
authors.initials: YL
authors.lastname: Cheng
authors.forename: Yuan-Jen
authors.initials: YJ
authors.lastname: Wang
authors.forename: Wei-Yu
authors.initials: WY
authors.lastname: Kao
authors.forename: Ping-Hsien
authors.initials: PH
authors.lastname: Chen
authors.forename: Teh-Ia
authors.initials: TI
authors.lastname: Huo
authors.forename: Yi-Hsiang
authors.initials: YH
authors.lastname: Huang
authors.forename: Keng-Hsin
authors.initials: KH
authors.lastname: Lan
authors.forename: Chien-Wei
authors.initials: CW
authors.lastname: Su
authors.forename: Wan-Leong
authors.initials: WL
authors.lastname: Chan
authors.forename: Han-Chieh
authors.initials: HC
authors.lastname: Lin
authors.forename: Fa-Yauh
authors.initials: FY
authors.lastname: Lee
authors.forename: Jaw-Ching
authors.initials: JC
authors.lastname: Wu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D015897:Comorbidity; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000378:metabolism; D006515:Hepatitis B virus / Q000302:isolation & purification* / Q000378:metabolism / Q000502:physiology; D019694:Hepatitis B, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D054884:Host-Pathogen Interactions; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D010976:Platelet Count; D015995:Prevalence; D013624:Taiwan / Q000453:epidemiology; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D006514:Hepatitis B Surface Antigens; D002784:Cholesterol; D000410:Alanine Transaminase