Effects Of Metabolic Syndrome On Viral Replication,Liver Inflammation And Fibrosis In Patients With Chronic Hepatitis B

Objective:To compare and analyze the clinical characteristics of CHB+MS patients and CHB patients,and to understand the effect of MS on the condition of CHB.Methods : A cross-sectional survey was used to collect 327 CHB patients who had not received anti-hepatitis B virus therapy in the first affiliated Hospital of Medical College of Shihezi University from January 2017 to August 2019.According to whether they were complicated with metabolic syndrome or not,they were divided into CHB+MS group and CHB group.There were 130 cases in CHB + MS group,89 males and 41 females,with an average age of(47.22 ± 10.53)years.There were 197 cases in CHB group,138 males and 59 females,with an average age of(46.20 ± 11.75)years.Before the treatment,the fasting elbow vein blood was collected,and the blood routine,blood biochemistry,hepatitis B two and a half,HBV DNA detection(the lower limit of HBV detection is 100 copies / ml)were completed with the hospital related instruments;the full-time inspection technician and imaging diagnosis physician in the imaging department of the hospital completed the liver,gallbladder and spleen color ultrasound,liver CT and liver elastic hardness scanning.The age,sex composition,BMI,liver injury grade composition,blood biochemistry,serum HBV DNA load,CAP,LSM,APRI model,FIB-4 index and other clinical indexes were compared and analyzed.Results:There was no significant difference in age,sex and liver injury grade between the two groups(p>0.05).(1)BMI,prevalence of hypertension,fasting blood glucose,TG,TC,LDL and uric acid in CHB +MS group were significantly higher than those in CHB group,while serum HDL-C was significantly lower than that in CHB + MS group(P < 0.05).(2)There was no difference in serum ALT,AST,albumin,globulin and TBIL between the two groups(P > 0.05),but the serum ? GGT level was significantly higher than the latter(P < 0.05).(3)The HBV DNA load in CHB + MS group was lower than that in CHB group(P < 0.05).(4)The mean value of LSM and Apri in CHB + MS group was higher than that in CHB group,but the difference was not statistically significant(P > 0.05);the mean value of cap and FIB-4 in CHB +MS group was significantly higher than that in CHB group,and the difference was statistically significant(P < 0.05).Conclusion:In chronic hepatitis B patients with metabolic syndrome,there was no significant increase in the enzyme index of reaction to liver inflammation,but the enzyme index of reaction metabolism increased.HBV replication may be inhibited in patients with metabolic syndrome.The incidence rate of progressive liver fibrosis in group CHB+MS was higher,and the incidence of moderate to severe fatty liver was higher.This suggests that metabolic syndrome may be an important reason for accelerating the progression of liver fibrosis in patients with chronic hepatitis B.