Analysis Of Risk Factors Of Chronic Hepatitis B With None-alcoholic Fatty Liver Disease

Objective(s):Chronic hepatitis B(Chronic Hepatitis B,CHB)and nonalcoholic fatty liver disease(Nonalcoholic Fatty Liver Disease,NAFLD)are common chronic liver diseases.Currently,14%-67% of CHB patients in Asia have NAFLD.Studies have found that the probability of developing hepatocellular carcinoma(HCC)in CHB patients combined with NAFLD will increase by about 7.3 times,which brings huge psychological and economic burdens to patients.In this study,the basic information,laboratory examination indicators,methane hydrogen breath test and liver transient elastography(Fibro Scan)results of CHB without NAFLD and CHB with NAFLD were retrospectively analyzed to explore the possibility of CHB with NAFLD.Related risk factors provide a theoretical basis for preventing the occurrence of CHB combined with NAFLD.Methods:This study is a cross-sectional study.The clinical data of 301 CHB patients who were treated in the Department of Gastroenterology,Building 3,The First Affiliated Hospital of Kunming Medical University from January 2021 to August 2022 were collected.According to the controlled attenuation parameter of Fibro Scan,CAP),the patients were divided into two groups,CHB without NAFLD group(CAP<238d B/m)and CHB with NAFLD group(CAP≥238d B/m),including 162 patients in CHB without NAFLD group,and CHB with NAFLD group 139 cases.Collect basic information of patients(sex,age,body mass index,waist circumference,hip circumference),laboratory test indicators(liver function,kidney function,blood lipids,blood routine,hepatitis B two-and-a-half quantitative,HBV-DNA),methane hydrogen breath The positive rate of the test and the CAP and liver stiffness value(Liver Stiffness Measurement,LSM)of Fibro Scan,and the above data were compared and analyzed between groups.The data were statistically analyzed using SPSS 26.0software.The t test was used for normal or approximately normal measurement data,the rank sum test was used for skewed distribution of measurement data,and the 2test was used for categorical variable data.The indicators with statistically significant differences between the above two groups were included in the univariate Logistic regression analysis,and then the indicators with statistical significance after the univariate Logistic regression analysis were included in the multivariate Logistic regression analysis to find out the independent risk factors of CHB combined with NAFLD,P <0.05 was considered statistically significant.Results:1.There were statistically significant differences in Body Mass Index(BMI),waist circumference,and hip circumference between CHB patients without NAFLD and CHB patients with NAFLD(P<0.05);There was no statistically significant difference(P>0.05).2.CHB patients without NAFLD and CHB patients with NAFLD were compared in alanine aminotransferase(Alanine Aminotransferase,ALT),glutamyl transpeptidase(Glutamyl Transpeptidase,γ-GGT),creatinine,total cholesterol,triglyceride,High Density Lipoprotein Cholesterol(HDL-C),Low Density Lipoprotein Cholesterol(LDL-C),red blood cells,hemoglobin,CAP,LSM and other groups,the difference was statistically significant(P<0.05);in total protein,albumin,aspartate aminotransferase(Aspartate Aminotransferase,AST),total bilirubin,direct bilirubin,alkaline phosphatase(Alkaline Phosphatase,ALP),blood urea nitrogen There was no statistically significant difference between groups such as blood,white blood cells,platelets,two-and-a-half pairs of hepatitis B,and HBV-DNA(P>0.05).3.There was no significant difference in SIBO positive rate,H2 positive rate,CH4 positive rate between CHB without NAFLD group and CHB with NAFLD group(P>0.05).4.Univariate Logistic regression analysis suggested that BMI,waist circumference,hip circumference,γ-GGT,creatinine,total cholesterol,triglyceride,HDL-C,LDL-C,red blood cells,and hemoglobin were risk factors for CHB combined with NAFLD(P< 0.05).Multivariate Logistic regression analysis indicated:high BMI(OR=0.044,95%CI 1.002-1.199,P=0.044),high triglycerides(OR=2.078,95%CI 1.192-3.179),low HDL-C(OR =0.251,95%CI 0.071-0.885)is an independent risk factor for CHB combined with NAFLD(P<0.05).Conclusion(s):1.CHB patients with NAFLD had larger BMI,waist circumference,and hip circumference.2.ALT,γ-GGT,creatinine,total cholesterol,triglyceride,LDL-C,red blood cells,hemoglobin were higher in CHB patients with NAFLD,and HDL-C was lower.3.CHB patients without NAFLD and CHB patients with NAFLD are prone to small intestinal bacterial overgrowth.4.High BMI,high triglycerides,and low HDL-C are independent risk factors for CHB combined with NAFLD.