慢性乙型肝炎患者合并非酒精性脂肪性肝病的大流行现状及影响
Prevalence and Impact of Nonalcoholic Fatty Liver Disease in Patients with Chronic Hepatitis B
摘要: 慢性乙型肝炎(chronic hepatitis B, CHB)是全球性的公共卫生难题。由于人们生活习惯的转变,中国及全球范围内的非酒精性脂肪性肝病(nonalcoholic fatty liver disease, NAFLD)患病率呈现持续上升态势。基于此,CHB与NAFLD共患病的现象也日渐增多。本综述探讨了CHB合并NAFLD的流行现状以及CHB患者并发NAFLD的肝纤维化、心血管疾病、肿瘤事件的风险。最后,本文探讨了NAFLD对CHB患者预后的影响。适当的管理和正确的治疗对CHB合并NAFLD患者不可或缺。
Abstract: Chronic hepatitis B (CHB) is a public health problem globally. With the change of people’s lifestyle, the prevalence of nonalcoholic fatty liver disease (NAFLD) in Asia and the world continues to rise. Based on this, the concurrence of CHB with NAFLD is increasing. This review discussed the preva-lence and the risk of liver fibrosis, cardiovascular disease and tumor events in CHB patients con-current with NAFLD. Finally, this article explores the impact of NAFLD on the prognosis of CHB pa-tients. Proper management and correct treatment are essential for CHB patients concurrent with NAFLD.
文章引用:徐琊芸. 慢性乙型肝炎患者合并非酒精性脂肪性肝病的大流行现状及影响[J]. 临床医学进展, 2023, 13(7): 11196-11201. https://doi.org/10.12677/ACM.2023.1371563

参考文献

[1] Collaborators GBDHB (2022) Global, Regional, and National Burden of Hepatitis B, 1990-2019: A Systematic Analysis for the Global Burden of Disease Study 2019. The Lancet Gastroenterology and Hepatology, 7, 796-829. [Google Scholar] [CrossRef
[2] Le, M.H., Yeo, Y.H., Li, X., et al. (2022) 2019 Global NAFLD Prevalence: A Systematic Review and Meta-Analysis. Clinical Gastroenterology and Hepatology, 20, 2809-2817.e28. [Google Scholar] [CrossRef] [PubMed]
[3] Li, J., Zou, B., Yeo, Y.H., et al. (2019) Prevalence, Incidence, and Outcome of Non-Alcoholic Fatty Liver Disease in Asia, 1999-2019: A Systematic Review and Me-ta-Analysis. The Lancet Gastroenterology and Hepatology, 4, 389-398. [Google Scholar] [CrossRef
[4] Zheng, Y., Xu, K., Hu, H., et al. (2021) Prevalence and In-cidence of Non-Alcohol Fatty Liver Disease in Chronic Hepatitis B Population in Southeast China: A Community-Based Study. Frontiers in Medicine (Lausanne), 8, Article ID: 683872. [Google Scholar] [CrossRef] [PubMed]
[5] Pais, R., Rusu, E., Zilisteanu, D., et al. (2015) Prevalence of Stea-tosis and Insulin Resistance in Patients with Chronic Hepatitis B Compared with Chronic Hepatitis C and Non-Alcoholic Fatty Liver Disease. European Journal of Internal Medicine, 26, 30-36. [Google Scholar] [CrossRef] [PubMed]
[6] Zheng, Q., Zou, B., Wu, Y., et al. (2021) Systematic Review with Meta-Analysis: Prevalence of Hepatic Steatosis, Fibrosis and Associated Factors in Chronic Hepatitis B. Alimentary Pharmacology & Therapeutics, 54, 1100-1109. [Google Scholar] [CrossRef] [PubMed]
[7] 王贵强, 段钟平, 王福生, 等. 慢性乙型肝炎防治指南(2019年版) [J]. 实用肝脏病杂志, 2020, 23(1): 9-32.
[8] Chalasani, N., Younossi, Z., Lavine, J.E., et al. (2018) The Diagnosis and Management of Nonalcoholic Fatty Liver Disease: Practice Guidance from the American Association for the Study of Liver Diseases. Hepatology, 67, 328-357. [Google Scholar] [CrossRef] [PubMed]
[9] Wong, V.W., Chu, W.C., Wong, G.L., et al. (2012) Prevalence of Non-Alcoholic Fatty Liver Disease and Advanced Fibrosis in Hong Kong Chinese: A Population Study Using Pro-ton-Magnetic Resonance Spectroscopy and Transient Elastography. Gut, 61, 409-415. [Google Scholar] [CrossRef] [PubMed]
[10] Younossi, Z.M. (2019) Non-Alcoholic Fatty Liver Disease—A Global Public Health Perspective. Journal of Hepatology, 70, 531-544. [Google Scholar] [CrossRef] [PubMed]
[11] Gao, H., Kuang, Z., Zhong, C.X., et al. (2019) Prevalence and Risk Factors of Nonalcoholic Fatty Liver Disease in Patients with Chronic Hepatitis B Receiving Antiviral Therapy. Chinese Journal of Hepatology, 27, 347-351.
[12] Targher, G., Byrne, C.D., Lonardo, A., et al. (2016) Non-Alcoholic Fatty Liver Disease and Risk of Incident Cardiovascular Disease: A Meta-Analysis. Journal of Hepatology, 65, 589-600. [Google Scholar] [CrossRef] [PubMed]
[13] Lee, S.B., Park, G.M., Lee, J.Y., et al. (2018) Association between Non-Alcoholic Fatty Liver Disease and Subclinical Coronary Atherosclerosis: An Observational Cohort Study. Journal of Hepatology, 68, 1018-1024. [Google Scholar] [CrossRef] [PubMed]
[14] Targher, G., Byrne, C.D. and Tilg, H. (2020) NAFLD and In-creased Risk of Cardiovascular Disease: Clinical Associations, Pathophysiological Mechanisms and Pharmacological Im-plications. Gut, 69, 1691-1705. [Google Scholar] [CrossRef] [PubMed]
[15] Kim, G.A., Lee, H.C., Choe, J., et al. (2017) Association between Non-Alcoholic Fatty Liver Disease and Cancer Incidence Rate. Journal of Hepatology.
[16] Mantovani, A., Petracca, G., Beatrice, G., et al. (2022) Non-Alcoholic Fatty Liver Disease and Increased Risk of Incident Extrahepatic Cancers: A Meta-Analysis of Observational Cohort Studies. Gut, 71, 778-788. [Google Scholar] [CrossRef] [PubMed]
[17] Choi, H.S.J., Brouwer, W.P., Zanjir, W.M.R., et al. (2020) Non-alcoholic Steatohepatitis Is Associated with Liver-Related Outcomes and All-Cause Mortality in Chronic Hepatitis B. Hepatology, 71, 539-548. [Google Scholar] [CrossRef] [PubMed]
[18] Mak, L.Y., Hui, R.W., Fung, J., et al. (2020) Diverse Effects of Hepatic Steatosis on Fibrosis Progression and Functional Cure in Virologically Quiescent Chronic Hepatitis B. Journal of Hepa-tology, 73, 800-806. [Google Scholar] [CrossRef] [PubMed]
[19] Hui, R.W.H., Seto, W.K., Cheung, K.S., et al. (2018) Inverse Rela-tionship between Hepatic Steatosis and Hepatitis B Viremia: Results of a Large Case-Control Study. Journal of Viral Hepatitis, 25, 97-104. [Google Scholar] [CrossRef] [PubMed]
[20] Mao, X., Cheung, K.S., Peng, C., et al. (2022) Steatosis, HBV-Related HCC, Cirrhosis, and HBsAg Seroclearance: A Systematic Review and Meta-Analysis. Hepatology, 77, 1735-1745. [Google Scholar] [CrossRef] [PubMed]
[21] Wu, V.C., Chen, T.H., Wu, M., et al. (2018) Comparison of Cardiovascular Outcomes and All-Cause Mortality in Patients with Chronic Hepatitis B and C: A 13-Year Nationwide Population-Based Study in Asia. Atherosclerosis, 269, 178-184. [Google Scholar] [CrossRef] [PubMed]
[22] Ranković, I., Milivojević, V., Pavlović Marković, A., et al. (2022) Interplay between Chronic Hepatitis B and Atherosclerosis: In-novative Perspectives and Theories. World Journal of Gastroenterology, 28, 497-499. [Google Scholar] [CrossRef] [PubMed]
[23] Riveiro-Barciela, M., Marcos-Fosch, C., Martinez-Valle, F., et al. (2021) Naïve Hepatitis B e Antigen-Negative Chronic Hepatitis B Patients Are at Risk of Carotid Atherosclerosis: A Prospective Study. World Journal of Gastroenterology, 27, 5112-5125. [Google Scholar] [CrossRef] [PubMed]
[24] Ishizaka, N., Ishizaka, Y., Takahashi, E., et al. (2002) Increased Prevalence of Carotid Atherosclerosis in Hepatitis B Virus Carriers. Circulation, 105, 1028-1030. [Google Scholar] [CrossRef] [PubMed]
[25] Chun, H.S., Lee, J.S., Lee, H.W., et al. (2022) Prevalence and Risk Factors of Cardiovascular Disease in Patients with Chronic Hepatitis B. Digestive Diseases and Sciences, 67, 3412-3425. [Google Scholar] [CrossRef] [PubMed]
[26] Cheng, J.Y., Wong, V.W., Tse, Y.K., et al. (2016) Metabolic Syndrome Increases Cardiovascular Events but Not Hepatic Events and Death in Patients with Chronic Hepatitis B. Hepatology, 64, 1507-1517. [Google Scholar] [CrossRef] [PubMed]
[27] Leow, Y.W., Chan, W.K., Goh, G.B.B., et al. (2023) Hepatic Steatosis and Metabolic Risk Factors among Patients with Chronic Hepatitis B: The Multicentre, Prospective CAP-Asia Study. Journal of Viral Hepatitis, 30, 319-326. [Google Scholar] [CrossRef] [PubMed]
[28] Stahl, E.P., Dhindsa, D.S., et al. (2019) Nonalcoholic Fatty Liver Disease and the Heart: JACC State-of-the-Art Review. JACC: Journal of the American College of Cardiology, 73, 948-963. [Google Scholar] [CrossRef] [PubMed]
[29] Peleg, N., Issachar, A., Sneh Arbib, O., et al. (2019) Liver Steatosis Is a Strong Predictor of Mortality and Cancer in Chronic Hepatitis B Regardless of Viral Load. JHEP Reports, 1, 9-16. [Google Scholar] [CrossRef] [PubMed]
[30] Hu, D., Wang, H., Wang, H., et al. (2018) Non-Alcoholic Hepatic Steatosis Attenuates Hepatitis B Virus Replication in an HBV-Immunocompetent Mouse Model. Hepatology Interna-tional, 12, 438-446. [Google Scholar] [CrossRef] [PubMed]
[31] Chen, Y., Liu, Q., Han, J., et al. (2022) A Meta-Analysis of How Nonalcoholic Fatty Liver Disease Affect Antiviral Treatment of Patients with e Antigen-Positive Chronic Hepatitis B. Emergency Medicine International, 2022, Article ID: 4774195. [Google Scholar] [CrossRef] [PubMed]