Metabolic syndrome increases the risk of liver cirrhosis in chronic hepatitis B

• Published in: Gut Vol. 58; no. 1; pp. 111 - 117
• Main Authors: Wong, G L-H, Wong, V W-S, Choi, P C-L, Chan, A W-H, Chim, A M-L, Yiu, K K-L, Chan, H-Y, Chan, F K-L, Sung, J J-Y, Chan, H L-Y
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Society of Gastroenterology 01.01.2009; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adult; Age Distribution; Biological and medical sciences; Biopsy; Body Mass Index; Elasticity Imaging Techniques; Epidemiologic Methods; Female; Gastroenterology. Liver. Pancreas. Abdomen; Hepatitis B; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - epidemiology; Hepatology; Hong Kong - epidemiology; Human viral diseases; Humans; Infectious diseases; Liver - pathology; Liver cancer; Liver cirrhosis; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - epidemiology; Liver Cirrhosis - etiology; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Metabolic diseases; Metabolic syndrome; Metabolic Syndrome - complications; Metabolic Syndrome - epidemiology; Metabolic Syndrome - pathology; Middle Aged; Miscellaneous; Other diseases. Semiology; Other metabolic disorders; Prospective Studies; Studies; Viral diseases; Viral hepatitis; Womens health; Endocrinopathy; Liver; Metabolic diseases; Cardiovascular disease; Hepatic disease; Metabolic syndrome; Infection; Viral hepatitis B; Cirrhosis; Viral disease; Risk factor; Gastroenterology; Digestive diseases
• ISSN: 0017-5749; 1468-3288; 1468-3288
• DOI: 10.1136/gut.2008.157735

Background:Metabolic syndrome is associated with non-alcoholic steatohepatitis and cryptogenic cirrhosis. Whether metabolic syndrome affects the severity of chronic hepatitis B (CHB) is unclear.Aim:We aimed to study the relationship between metabolic syndrome and the risk of liver cirrhosis in patients with CHB.Methods:We prospectively recruited patients with CHB from primary care and hospital clinics for liver stiffness measurement (LSM) with transient elastography to diagnose early cirrhosis. Probable cirrhosis was defined as LSM ⩾13.4 kPa. We analysed a subgroup of patients with paired LSM and liver biopsies to validate the accuracy of LSM.Results:1466 patients had reliable LSM and 134 (9%) patients had adequate liver biopsy. 188 (13%) patients had metabolic syndrome. Histological liver cirrhosis was present in 32/134 (24%) patients. Histological liver cirrhosis was more common among patients who had metabolic syndrome (38%) versus those who did not (11%, p<0.001). The specificity of probable cirrhosis on LSM for histological cirrhosis was 94%. Probable cirrhosis was present in 187 (13%) patients. Metabolic syndrome was more prevalent in patients with probable cirrhosis (24%) than those without cirrhosis (11%, p<0.001). After adjustment for anthropometric, biochemical and virological factors, metabolic syndrome remained an independent factor associated with probable cirrhosis (odds ratio 1.7, 95% confidence interval (CI) 1.1 to 2.6). The odds ratios of probable cirrhosis were 1.4 (95% CI, 0.9 to 2.3), 2.6 (95% CI, 1.7 to 4.3), 4.1 (95% CI, 2.4 to 7.1), 4.0 (95% CI, 1.9 to 8.4) and 5.5 (95% CI, 1.8 to 16.7) in patients with one, two, three, four and five components of metabolic syndrome, respectively.Conclusion:Metabolic syndrome is an independent risk factor of liver cirrhosis in CHB.