Wang MF, Wan B, Wu YL, Huang JF, Zhu YY, Li YB. Clinic-pathological features of metabolic associated fatty liver disease with hepatitis B virus infection. World J Gastroenterol 2021; 27(4): 336-344 [PMID: 33584066 DOI: 10.3748/wjg.v27.i4.336]
Corresponding Author of This Article
You-Bing Li, PhD, Associate Chief Physician, Department of Liver Research Center, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang District, Fuzhou 350005, Fujian Province, China. liyoubing1976@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jan 28, 2021; 27(4): 336-344 Published online Jan 28, 2021. doi: 10.3748/wjg.v27.i4.336
Clinic-pathological features of metabolic associated fatty liver disease with hepatitis B virus infection
Ming-Fang Wang, Bo Wan, Yin-Lian Wu, Jiao-Feng Huang, Yue-Yong Zhu, You-Bing Li
Ming-Fang Wang, Department of Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
Bo Wan, Institute of Neurology, University College London, London WC1N 3BG, United Kingdom
Yin-Lian Wu, Jiao-Feng Huang, Yue-Yong Zhu, You-Bing Li, Department ofLiver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
Author contributions: Wang MF and Li YB designed the study; Huang JF and Wu YL collected and analyzed the data; Wang MF and Wan B drafted the manuscript; Zhu YY and Li YB critically revised the manuscript; Wang MF and Wan B contributed equally to this work; all authors approved the final version of the manuscript prior to submission.
Supported byChinese National 13th Five-Year Plan's Science and Technology Projects, No. 2017ZX10202201.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Fujian Medical University in accordance with the Declaration of Helsinki.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: You-Bing Li, PhD, Associate Chief Physician, Department of Liver Research Center, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang District, Fuzhou 350005, Fujian Province, China. liyoubing1976@sina.com
Received: October 9, 2020 Peer-review started: October 9, 2020 First decision: December 3, 2020 Revised: December 11, 2020 Accepted: December 22, 2020 Article in press: December 22, 2020 Published online: January 28, 2021 Processing time: 107 Days and 15.1 Hours
ARTICLE HIGHLIGHTS
Research background
Metabolic associated fatty liver disease (MAFLD) is a novel concept proposed in 2020.
Research motivation
MAFLD does not require the exclusion of hepatitis B virus (HBV) infection, thus the combination of HBV and MAFLD (HBV-MAFLD) would become an important subtype of MAFLD. The clinicopathological characteristics of this subtype are unclear.
Research objectives
This retrospective study aimed to compare the characteristics between MAFLD and HBV-MAFLD.
Research methods
Patients with histopathologically proven MAFLD from a single medical center were included. Patients were divided into MAFLD group (without HBV infection) and HBV-MAFLD group (with HBV infection). Propensity score matching was utilized to balance the baseline characteristics between two groups.
Research results
A total of 417 cases with MAFLD were included, 359 (86.1%) of whom were infected with HBV. There were significantly more males in the HBV-MAFLD group than in MAFLD group (P < 0.05). After propensity score matching, 58 pairs were successfully matched with no significant differences found in gender, age, body mass index, lipid levels, liver enzymes, and the other metabolic associated comorbidities between two groups (P > 0.05). The rank sum test results showed that the degree of liver steatosis in the MAFLD group was more severe than that in HBV-MAFLD group, while the degree of inflammation and fibrosis in liver was less severe (P < 0.05). In multivariate analysis, HBV infection was associated with lower grade of hepatic steatosis [odds ratio (OR) = 0.088, 95% confidence interval (CI): 0.027-0.291] but higher inflammation (OR = 4.059, 95%CI: 1.403-11.742) and fibrosis grades (OR = 3.016, 95%CI: 1.087-8.370) after adjusting for age, gender, and other metabolic parameters.
Research conclusions
HBV infection is associated with similar metabolic risks, lower steatosis grade, and higher inflammation and fibrosis grade in MAFLD patients.
Research perspectives
The overall body mass index and the prevalence of metabolic disorder were relatively low in this study cohort. The conclusion should be validated in other populations with more metabolic dysfunctions.
