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Inverse association between hepatitis B virus infection and fatty liver disease: a large-scale study in populations seeking for check-up.

Cheng YL, Wang YJ, Kao WY, Chen PH, Huo TI, Huang YH, Lan KH, Su CW, Chan WL, Lin HC, Lee FY, Wu JC - PLoS ONE (2013)

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

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).

Aim: 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.

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The flow of subjects in the study.
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pone-0072049-g001: The flow of subjects in the study.

Mentions: There were 34,346 subjects receiving health check-up services at the Taipei Veterans General Hospital from 2002 to 2009 [2], [19]. As shown in Figure 1, those who had chronic HCV infection were excluded and the remaining 33,439 subjects were included in the analysis. All of them underwent complete clinical evaluation, laboratory examination and abdominal sonography. BMI was the result of the division of the body weight (in kilograms) by the square body height (in meters). We adopted a normal body mass index (BMI) was between 17.5 and 22.4 kg/m2, an overweight BMI between 22.5 and 24.9 kg/m2, and an obese BMI higher than 25 kg/m2[20]. Blood pressure (BP) was measured after the subjects had been seated for more than 5 min. The means of three consecutive readings were recorded as systolic and diastolic BP with a difference in systolic BP<10 mmHg. Ultrasonography with Aloka SSD 4000 (Aloka, Tokyo, Japan), Aloka SSD 5000 (Aloka) or Philips HD 15 (Philips, Bothell, WA, USA) were used to diagnose fatty liver by the practice guideline of the American Gastroenterological Association [1]. The study followed the standards of the Declaration of Helsinki and has been approved by the Institutional Review Board of the Taipei Veterans General Hospital (2011-08-010IC). As the dataset used in this study is consisted of de-identified data from a retrospective cohort, the written informed consents from the subjects who receiving physical check-up services were waived by the approval of the IRB.


Inverse association between hepatitis B virus infection and fatty liver disease: a large-scale study in populations seeking for check-up.

Cheng YL, Wang YJ, Kao WY, Chen PH, Huo TI, Huang YH, Lan KH, Su CW, Chan WL, Lin HC, Lee FY, Wu JC - PLoS ONE (2013)

The flow of subjects in the study.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3750031&req=5

pone-0072049-g001: The flow of subjects in the study.
Mentions: There were 34,346 subjects receiving health check-up services at the Taipei Veterans General Hospital from 2002 to 2009 [2], [19]. As shown in Figure 1, those who had chronic HCV infection were excluded and the remaining 33,439 subjects were included in the analysis. All of them underwent complete clinical evaluation, laboratory examination and abdominal sonography. BMI was the result of the division of the body weight (in kilograms) by the square body height (in meters). We adopted a normal body mass index (BMI) was between 17.5 and 22.4 kg/m2, an overweight BMI between 22.5 and 24.9 kg/m2, and an obese BMI higher than 25 kg/m2[20]. Blood pressure (BP) was measured after the subjects had been seated for more than 5 min. The means of three consecutive readings were recorded as systolic and diastolic BP with a difference in systolic BP<10 mmHg. Ultrasonography with Aloka SSD 4000 (Aloka, Tokyo, Japan), Aloka SSD 5000 (Aloka) or Philips HD 15 (Philips, Bothell, WA, USA) were used to diagnose fatty liver by the practice guideline of the American Gastroenterological Association [1]. The study followed the standards of the Declaration of Helsinki and has been approved by the Institutional Review Board of the Taipei Veterans General Hospital (2011-08-010IC). As the dataset used in this study is consisted of de-identified data from a retrospective cohort, the written informed consents from the subjects who receiving physical check-up services were waived by the approval of the IRB.

Bottom Line: 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.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.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.

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).

Aim: 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.

Show MeSH
Related in: MedlinePlus