Clinical profiles and their interaction of concurrent metabolic associated steatotic liver disease and hepatitis B virus infection

doi:10.4254/wjh.v16.i12.1429

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World Journal of Hepatology

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World J Hepatol. Dec 27, 2024; 16(12): 1429-1440
Published online Dec 27, 2024. doi: 10.4254/wjh.v16.i12.1429

Table 1 Clinical characteristics between resolved hepatitis B virus patients and healthy controls before and after propensity score matching for age and sex

Characteristic	Before PSM			After PSM
Characteristic	Resolved HBV, n = 11186	Healthy controls, n = 5666	P value	Resolved HBV, n = 5015	Healthy controls, n = 5015	P value
Age, year	57.41 ± 9.31	51.29 ± 11.25	< 0.001	53.39 ± 10.23	53.32 ± 10.32	0.729
Male	3445 (30.80)	1553 (27.41)	< 0.001	1252 (24.97)	1331 (26.54)	0.071
BMI, kg/m²	24.20 ± 3.60	24.13 ± 3.88	0.266	24.12 ± 3.83	24.16 ± 3.82	0.619
Body fat %	29.41 ± 7.46	29.52 ± 7.44	0.375	29.87 ± 7.45	29.71 ± 7.42	0.309
WC, cm	83.48 ± 9.78	82.82 ± 10.32	< 0.001	82.66 ± 10.10	83.02 ± 10.15	0.076
Metabolic parameters
MASLD	4670 (41.75)	2229 (39.34)	0.003	2007 (40.02)	2033 (40.54)	0.597
Diabetes	1383 (12.36)	474 (8.37)	< 0.001	503 (10.03)	463 (9.23)	0.176
Hypertension	2072 (18.52)	724 (12.78)	< 0.001	731 (14.58)	711 (14.18)	0.569
Hyperlipidemia	1431 (12.79)	548 (9.67)	< 0.001	499 (9.95)	539 (10.75)	0.190
Glucose, mg/dL	98 (21.71)	95 (19.00)	< 0.001	97 (21.48)	96 (19.25)	0.166
HbA1c, %	5.93 ± 0.84	5.80 ± 0.75	< 0.001	5.86 ± 0.84	5.83 ± 0.77	0.106
TG, mg/dL	120.91 ± 99.13	115.42 ± 77.93	< 0.001	118.04 ± 116.37	117.85 ± 78.99	0.924
CHO, mg/dL	199.78 ± 36.71	197.94 ± 36.28	0.002	198.72 ± 36.05	199.22 ± 36.07	0.482
HDL, mg/dL	55.26 ± 13.62	55.89 ± 13.74	0.005	55.80 ± 13.57	55.96 ± 13.74	0.568
LDL, mg/dL	122.75 ± 32.30	121.78 ± 32.15	0.065	122.19 ± 31.92	122.44 ± 31.91	0.695
Liver parameters
AST, U/L	25.11 ± 11.28	24.35 ± 12.12	< 0.001	24.31 ± 12.71	24.56 ± 12.29	0.325
ALT, U/L	23.05 ± 20.82	23.10 ± 22.66	0.885	22.48 ± 24.76	23.24 ± 23.11	0.113
GGT, U/L	22.74 ± 25.62	22.21 ± 20.17	0.138	21.79 ± 25.47	22.47 ± 20.53	0.143
Fatty liver index	25.73 ± 23.03	24.85 ± 24.05	0.023	24.48 ± 23.63	25.25 ± 23.87	0.103
FIB-4	1.46 ± 0.74	1.23 ± 0.61	< 0.001	1.30 ± 0.61	1.30 ± 0.62	0.550
FIB-4 > 2	1739 (15.55)	578(10.20)	< 0.0001	558 (11.13)	576 (11.49)	0.5703
Other parameters
Carotid plaque	3684 (32.93)	1266 (22.34)	< 0.001	1253 (24.99)	1250 (24.93)	0.945

Data are n (%). PSM: Propensity score matching; HBV: Hepatitis B virus; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; CHO: Cholesterol; FIB-4: Fibrosis-4; GGT: γ-glutamyl transferase; HbA1c: Glycated hemoglobin; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; MASLD: Metabolic dysfunction-associated steatotic liver disease; TG: triglycerides; WC: Waist circumference.

Table 2 Clinical characteristics between hepatitis B virus carrier and healthy controls before and after propensity score matching for age and sex

Characteristic	Before PSM			After PSM
Characteristic	HBV carrier, n = 2128	Healthy controls, n = 5666	P value	HBV carrier, n = 2128	Healthy controls, n = 2128	P value
Age, year	53.85 ± 9.68	51.29 ± 11.25	< 0.001	53.85 ± 9.68	53.88 ± 9.71	0.926
Male	775 (36.42)	1553 (27.41)	< 0.001	775 (36.42)	772 (36.28)	0.924
BMI, kg/m²	24.16 ± 3.65	24.13 ± 3.88	0.778	24.16 ± 3.65	24.32 ± 3.80	0.151
Body fat %	28.66 ± 7.67	29.52 ± 7.44	< 0.001	28.66 ± 7.67	28.76 ± 7.62	0.670
WC, cm	83.27 ± 10.29	82.82 ± 10.32	0.086	83.27 ± 10.29	83.83 ± 10.14	0.072
Metabolic parameters
MASLD	755 (35.48)	2229 (39.34)	0.002	755 (35.48)	925 (43.47)	< 0.001
Diabetes	204 (9.59)	474 (8.37)	0.088	204 (9.59)	206 (9.68)	0.917
Hypertension	293 (13.77)	724 (12.78)	0.247	293 (13.77)	330 (15.51)	0.109
Hyperlipidemia	182 (8.55)	548 (9.67)	0.131	182 (8.55)	244 (11.47)	0.002
Glucose, mg/dL	96 (21.23)	95 (19.00)	0.036	96 (21.23)	97 (21.66)	0.325
HbA1c, %	5.83 ± 0.83	5.80 ± 0.75	0.110	5.83 ± 0.83	5.86 ± 0.84	0.205
TG, mg/dL	107.73 ± 73.91	115.42 ± 77.93	< 0.001	107.73 ± 73.91	121.34 ± 80.35	< 0.001
CHO, mg/dL	194.28 ± 35.76	197.94 ± 36.28	< 0.001	194.28 ± 35.76	198.76 ± 35.46	< 0.001
HDL, mg/dL	55.23 ± 13.62	55.89 ± 13.74	0.059	55.23 ± 13.62	54.74 ± 13.70	0.242
LDL, mg/dL	118.93 ± 31.26	121.78 ± 32.15	< 0.001	118.93 ± 31.26	122.86 ± 31.63	< 0.001
Liver parameters
AST, U/L	27.97 ± 15.57	24.35 ± 12.12	< 0.001	27.97 ± 15.57	24.71 ± 10.15	< 0.001
ALT, U/L	28.57 ± 29.68	23.10 ± 22.66	< 0.001	28.57 ± 29.68	23.63 ± 17.79	< 0.001
GGT, U/L	20.03 ± 19.47	22.21 ± 20.17	< 0.001	20.03 ± 19.47	23.47 ± 22.09	< 0.001
Fatty liver index	23.12 ± 21.76	24.85 ± 24.05	0.004	23.12 ± 21.76	26.89 ± 24.28	< 0.001
FIB-4	1.49 ± 0.75	1.23 ± 0.61	< 0.001	1.49 ± 0.75	1.31 ± 0.59	< 0.001
FIB-4 > 2	407 (19.13)	578 (10.20)	< 0.0001	407 (19.13)	260 (12.22)	< 0.0001
Other parameter
Carotid plaque	533 (25.05)	1266 (22.34)	0.012	533 (25.05)	566 (26.60)	0.248

Data are n (%). PSM: Propensity score matching; HBV: Hepatitis B virus; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; CHO: Cholesterol; FIB-4: Fibrosis-4; GGT: γ-glutamyl transferase; HbA1c: Glycated hemoglobin; HDL: High-density lipoprotein; LDL: low-density lipoprotein; MASLD: Metabolic dysfunction-associated steatotic liver disease; TG: Triglycerides; WC: Waist circumference.

Table 3 Clinical characteristics between “dual etiology” group and “metabolic associated steatotic liver disease alone” group before and after propensity score matching for age and sex

Characteristic	Before PSM			After PSM
Characteristic	Dual etiology, n = 755	MASLD alone, n = 6899	P value	Dual etiology, n = 755	MASLD alone, n = 755	P value
Age, year	53.83 ± 9.62	56.09 ± 10.08	< 0.001	53.83 ± 9.62	53.83 ± 9.62	> 0.999
Male	324 (42.91)	2536 (36.76)	0.001	324 (42.91)	324 (42.91)	> 0.999
BMI, kg/m²	26.25 ± 3.69	26.13 ± 3.66	0.387	26.25 ± 3.69	26.25 ± 3.69	0.988
Body fat %	31.32 ± 7.66	31.87 ± 7.52	0.058	31.32 ± 7.66	31.20 ± 7.88	0.757
WC, cm	88.76 ± 10.41	88.44 ± 9.37	0.369	88.76 ± 10.41	89.01 ± 9.62	0.628
Metabolic parameters
Diabetes	135 (17.88)	1275 (18.48)	0.686	135 (17.88)	144 (19.07)	0.551
Hypertension	153 (20.26)	1,591 (23.06)	0.082	153 (20.26)	154 (20.40)	0.949
Hyperlipidemia	93 (12.32)	1091 (15.81)	0.012	93 (12.32)	103 (13.64)	0.444
Glucose, mg/dL	102 (26.32)	102 (25.71)	0.961	102 (26.32)	104 (31.15)	0.197
HbA1c, %	6.11 ± 1.06	6.12 ± 0.98	0.716	6.11 ± 1.06	6.17 ± 1.20	0.261
TG, mg/dL	139.82 ± 96.00	154.43 ± 120.06	< 0.001	139.82 ± 96.00	165.52 ± 230.03	0.005
CHO, mg/dL	196.49 ± 38.11	200.82 ± 37.26	0.003	196.49 ± 38.11	203.09 ± 36.60	0.001
HDL, mg/dL	49.71 ± 11.55	49.75 ± 11.44	0.931	49.71 ± 11.55	48.94 ± 11.41	0.191
LDL, mg/dL	123.25 ± 33.16	125.89 ± 33.29	0.038	123.25 ± 33.16	128.21 ± 33.23	0.004
Liver parameters
AST, U/L	28.70 ± 13.27	26.72 ± 14.20	< 0.001	28.70 ± 13.27	26.03 ± 9.82	< 0.001
ALT, U/L	33.40 ± 26.16	29.62 ± 26.51	< 0.001	33.40 ± 26.16	29.10 ± 18.42	< 0.001
GGT, U/L	24.21 ± 16.74	27.96 ± 28.63	< 0.001	24.21 ± 16.74	28.91 ± 24.95	< 0.001
Fatty liver index	37.72 ± 23.66	39.99 ± 24.69	0.016	37.72 ± 23.66	41.90 ± 25.45	0.001
FIB-4	1.35 ± 0.64	1.30 ± 0.66	0.064	1.35 ± 0.64	1.22 ± 0.57	< 0.001
FIB-4 > 2	100 (13.25)	699 (10.13)	0.0079	100 (13.25)	59 (7.81)	0.0006
Other parameters
Carotid plaque	198 (26.23)	2307 (33.44)	< 0.001	198 (26.23)	208 (27.55)	0.562

Data are n (%). PSM: Propensity score matching; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; BMI: Body mass index; CHO: Cholesterol; FIB-4: Fibrosis-4; GGT: γ-glutamyl transferase; HbA1c: Glycated hemoglobin; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; MASLD: Metabolic dysfunction-associated steatotic liver disease; TG: Triglycerides; WC: Waist circumference;

Table 4 Clinical characteristics between “dual etiology” group and “hepatitis B virus alone” group before and after propensity score matching for age and sex

Characteristic	Before PSM			After PSM
Characteristic	Dual etiology, n = 755	HBV alone, n = 1373	P value	Dual etiology, n = 755	HBV alone, n = 755	P value
Age, year	53.83 ± 9.62	53.87 ± 9.72	0.932	53.83 ± 9.62	53.80 ± 9.58	0.957
Male	324 (42.91)	451 (32.85)	< 0.001	324 (42.91)	324 (42.91)	> 0.999
BMI, kg/m²	26.25 ± 3.69	23.00 ± 3.07	< 0.001	26.25 ± 3.69	23.05 ± 3.09	< 0.001
Body fat %	31.32 ± 7.66	27.20 ± 7.27	< 0.001	31.32 ± 7.66	26.04 ± 7.60	< 0.001
WC, cm	88.76 ± 10.41	80.24 ± 8.88	< 0.001	88.76 ± 10.41	80.45 ± 8.87	< 0.001
Metabolic parameters
Diabetes	135 (17.88)	69 (5.03)	< 0.001	135 (17.88)	41 (5.43)	< 0.001
Hypertension	153 (20.26)	140 (10.20)	< 0.001	153 (20.26)	81 (10.73)	< 0.001
Hyperlipidemia	93 (12.32)	89 (6.48)	< 0.001	93 (12.32)	58 (7.68)	0.003
Glucose, mg/dL	102 (26.32)	93 (16.97)	< 0.001	102 (26.32)	94 (20.10)	< 0.001
HbA1c, %	6.11 ± 1.06	5.68 ± 0.62	< 0.001	6.11 ± 1.06	5.69 ± 0.70	< 0.001
TG, mg/dL	139.82 ± 96.00	90.08 ± 50.25	< 0.001	139.82 ± 96.00	91.52 ± 51.42	< 0.001
CHO, mg/dL	196.49 ± 38.11	193.06 ± 34.35	0.040	196.49 ± 38.11	193.44 ± 34.53	0.104
HDL, mg/dL	49.71 ± 11.55	58.27 ± 13.73	< 0.001	49.71 ± 11.55	57.96 ± 13.89	< 0.001
LDL, mg/dL	123.25 ± 33.16	116.55 ± 29.91	< 0.001	123.25 ± 33.16	117.00 ± 30.02	< 0.001
Liver parameters
AST, U/L	28.70 ± 13.27	27.56 ± 16.69	0.084	28.70 ± 13.27	28.10 ± 15.93	0.426
ALT, U/L	33.40 ± 26.16	25.91 ± 31.13	< 0.001	33.40 ± 26.16	27.29 ± 34.92	< 0.001
GGT, U/L	24.21 ± 16.74	17.73 ± 20.46	< 0.001	24.21 ± 16.74	18.88 ± 23.99	< 0.001
Fatty liver index	37.72 ± 23.66	15.09 ± 15.64	< 0.001	37.72 ± 23.66	15.85 ± 16.07	< 0.001
FIB-4	1.35 ± 0.64	1.57 ± 0.80	< 0.001	1.35 ± 0.64	1.61 ± 0.78	< 0.001
FIB-4 > 2	100 (13.25)	307 (22.36)	< 0.0001	100 (13.25)	185 (24.50)	< 0.001
Other parameters
Carotid plaque	198 (26.23)	335 (24.40)	0.352	198 (26.23)	194 (25.70)	0.814

Table 5 Factors associated with advanced liver fibrosis (Fibrosis-4 index > 2.67) in metabolic associated steatotic liver disease patients using binary logistic regression for 7654 study participants

Factor	Univariate			Multivariate
Factor	OR	95%CI	P value	AOR	95%CI	P value
Age, year	1.147	(1.123-1.172)	< 0.001	1.151	(1.126-1.177)	< 0.001
Male	0.986	(0.749-1.299)	0.922
BMI, kg/m²	0.975	(0.939-1.013)	0.189
Body fat, %	0.989	(0.971-1.007)	0.217
WC, cm	1.006	(0.992-1.020)	0.406
Diabetes mellitus	1.767	(1.313-2.379)	< 0.001	0.919	(0.593-1.424)	0.706
Hypertension	1.563	(1.172-2.084)	0.002	0.734	(0.536-1.005)	0.054
Dyslipidemia	1.511	(1.091-2.092)	0.013	1.009	(0.715-1.422)	0.961
Glucose, mg/dL	1.006	(1.002-1.009)	0.004	0.999	(0.991-1.007)	0.791
HbA1c, %	1.191	(1.077-1.316)	0.001	1.149	(0.903-1.462)	0.259
Triglyceride, mg/dL	1.000	(0.999-1.001)	0.869
Cholesterol, mg/dL	0.993	(0.989-0.997)	< 0.001	1.000	(0.992-1.008)	0.998
HDL, mg/dL	1.007	(0.996-1.018)	0.219
LDL, mg/dL	0.990	(0.985-0.994)	< 0.001	0.993	(0.984-1.001)	0.089
AST, U/L	1.050	(1.043-1.056)	< 0.001
ALT, U/L	1.013	(1.009-1.017)	< 0.001
GGT, U/L	1.004	(1.001-1.006)	0.006	1.004	(1.001-1.007)	0.011
FLI	1.001	(0.996-1.007)	0.615
HBV	1.546	(1.055-2.265)	0.025	2.154	(1.446-3.209)	< 0.001

ALT: Alanine aminotransferase; AOR: Adjusted odds ratio; AST: Aspartate aminotransferase; BMI: Body mass index; CI: Confidence interval; FLI: Fatty liver index; GGT: γ-glutamyl transferase; HbA1c: Glycated hemoglobin; HBV: Hepatitis B virus; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; OR: Odds ratio; WC: Waist circumference.

Citation: Wang SW, Chang YW, Wang C, Cheng YM, Hsieh TH, Wang CC, Kao JH. Clinical profiles and their interaction of concurrent metabolic associated steatotic liver disease and hepatitis B virus infection. World J Hepatol 2024; 16(12): 1429-1440
URL: https://www.wjgnet.com/1948-5182/full/v16/i12/1429.htm
DOI: https://dx.doi.org/10.4254/wjh.v16.i12.1429