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Metabolic syndrome increases the risk of liver fibrosis progression in chronic hep B

Coincidental metabolic syndrome increases the risk of liver fibrosis progression in patients with chronic hepatitis B, reports the latest issue of Alimentary Pharmacology & Therapeutics.

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Metabolic syndrome is a known risk factor of cirrhosis in chronic hepatitis B (CHB).

Dr Wong and colleagues from China investigated the effects of coincidental metabolic syndrome on liver fibrosis progression in treatment-nave chronic hepatitis B patients.

A total of 1466 chronic hepatitis B patients underwent liver stiffness measurement (LSM) by transient elastography in 20062008.

The researchers reported that 663 patients remained treatment-nave, and had second LSM in 20102012.

Liver fibrosis progression was defined as an increase in liver stiffness measurement ≥30% at the second assessment.

16% of patients developed liver fibrosis progression
Alimentary Pharmacology & Therapeutics

The impact of coincidental metabolic syndrome and its factors on liver fibrosis progression were evaluated after adjustment for viral load and hepatitis activity.

At baseline, the mean age was 43 years, 55% were males, serum alanine aminotransferase (ALT) was 44 IU/L, HBV DNA was 4 log IU/mL, and liver stiffness measurement was 6.3 kPa.

The researchers diagnosed metabolic syndrome in 12%, and 21% patients at baseline and follow-up visit, respectively.

The team found that 13% and 3% of patients had coincidental and resolved metabolic syndrome, at baseline and follow-up, respectively.

After an interval of 44 months, the researchers observed that 16% of patients developed liver fibrosis progression.

Coincidental metabolic syndrome, central obesity and low level of high-density lipoprotein cholesterol were associated with liver fibrosis progression independent of change in viral load and ALT level.

The research team noted effects of coincidental metabolic syndrome were most apparent in the immune-tolerant phase.

Dr Wong's team concludes, "Coincidental metabolic syndrome increases the risk of liver fibrosis progression in patients with chronic hepatitis B infection, independent of viral load and hepatitis activity."

Aliment Pharmacol Ther 2014: 39(8): 883893
02 April 2014

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