Analysis Of Clinical Characteristics Of Chronic Hepatitis B Combined With Nonalcoholic Fatty Liver Disease

Objective:To analyze the clinical features of chronic hepatitis B combined with nonalcoholic fatty liver disease.MATERIALS AND METHODS:Patients with Chronic hepatitis B who were admitted to our hospital at 2015.1-2018.12 were included in the study.A total of 379 patients were included in the study.According to whether had NAFLD,they were divided into NAFLD group(86 cases).NAFLD group(293 cases).Height,weight,and BMI(Kg/m2)were calculated for all subjects.All subjects were tested for blood routine,liver function(AST,ALT,GGT,ALP,ALB),serum lipids(TC,TG,HDL-C,LDL-C),fasting blood glucose(FBG),uric acid(UA)and other serology Indicators,as well as virological indicators such as HBsAg,HBeAg,and HBV DNA,and FIB-4,APRI,and GFR were calculated according to the formula.All patients underwent abdominal color Doppler ultrasound and Fibrotouch examination.Charts and statistical analysis were performed using Excel and SPSS 23.0 software,respectively.Result:(1)Compared with patients without NAFLD,the NAFLD group had a higher proportion of males,higher body height,body weight and BMI(P<0.05).(2)In the NAFLD group,the proportion of overweight and obese patients was significantly higher than that in the NAFLD group(P<0.001).(3)Compared with patients without NAFLD,the levels of alanine aminotransferase,uric acid and triglyceride in NAFLD group were higher(P<0.05),and the levels of high-density lipoprotein cholesterol and HBV DNA were lower(P<0.05).(4)HBV DNA levels were negatively correlated with CAP,triglyceride,BMI levels,diabetes and hypertension,and positively correlated with high-density lipoprotein levels(r-0.176,-0.179,-0.136,-0.112,-0.139,0.184;P 0.001,0.002,0.008,0.029,0.007,0.001).(5)NAFLD was independently associated with elevated BMI(OR 1.213,95%CI 1.088-1.353,P<0.05)and uric acid(OR 1.007,95%CI 1.002-1.013,P<0.05).(6)Compared with non-NAFLD group,the CAP value of NAFLD group was significantly higher(P<0.001),but there was no significant difference between LSM,FIB-4,APRI,GFR,GGT and platelet.(7)There was no significant correlation between CAP and non-invasive indicators of liver fibrosis such as LSM,FIB-4,APRI,GPR,GGT and platelets.Conclusion:1.The occurrence of NAFLD in CHB is mainly affected by metabolic factors and independently related to the increase of BMI and UA levels.2.The level of HBV DNA decreased when CHB combined with NAFLD.3.There was no significant correlation between the occurrence of NAFLD in CHB and the progression of liver fibrosis.