title: A noninvasive diagnostic model to assess nonalcoholic hepatic steatosis in patients with chronic hepatitis B.
abstract: OBJECTIVE
  The objective of this study was to develop a noninvasive diagnostic test for nonalcoholic hepatic steatosis in patients with chronic hepatitis B (CHB) by using routinely available clinical markers.
  
  
  METHODS
  A retrospective study of patients with CHB, with or without hepatic steatosis (fatty change) who were diagnosed with controlled attenuation parameter (CAP) measured by transient elastography were included. Patient information was analyzed on lifestyle; laboratory tests, including serum lipid levels; blood pressure; blood uric acid; and medical history of type 2 diabetes mellitus (T2DM).
  
  
  RESULTS
  A total of 1312 patients were included in the study; 618 patients had confirmed hepatic steatosis. The CAP levels were significantly correlated with patient height (p< 0.001), weight (p< 0.001), waistline measurement (p< 0.001), hipline measurement (p< 0.001), and diastolic blood pressure (DBP) (p< 0.001). Multivariate logistic regression analysis resulted in the development of an equation for the diagnostic of simple steatosis: the fatty liver (FL) test. The area under the receiver operating characteristic (AUROC) curve of the FL test was 0.79 (p< 0.001) in the training group and 0.82 in the validation group. When the FL test was >-0.425, the sensitivity, specificity, positive likelihood ratio (LR) and negative LR were 74.72%, 72.12%, 2.68, and 0.35 respectively. The average FL test result was -0.54 ± 1.26 in patients with CHB without hypertension, and 0.42 ± 1.35, 1.12 ± 1.65, and 1.98 ± 1.22 in patients with hypertension grade 1, 2, and 3, respectively (p< 0.001).
  
  
  CONCLUSIONS
  This study has demonstrated a noninvasive test for hepatic steatosis in patients with CHB.
authors.affiliation: Department of infectious diseases, First Affiliated Hospital of Xiamen University, Fujian Province, China.
authors.forename: Hongjie
authors.initials: H
authors.lastname: Ou
authors.affiliation: Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, China Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Shaohang
authors.initials: S
authors.lastname: Cai
authors.affiliation: The First people's hospital of Shunde, Guangdong Province, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangdong Province, China.
authors.forename: Muye
authors.initials: M
authors.lastname: Xia
authors.affiliation: Department of Infectious Diseases and Hepatology Unit, Nanfang Hospital, Southern Medical University, Guangdong Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Peng
keywords: blood pressure; chronic hepatitis B; controlled attenuation parameter; hepatic steatosis; hepatitis B virus; nonalcoholic fatty liver disease