Chronic hepatitis B associated with hepatic steatosis, insulin resistance, necroinflammation and fibrosis

B Yilmaz, S Koklu, H Buyukbayram, K Yalçin, U Korkmaz, E Posul, G Can, M Kurt

Abstract

Background: The effect of hepatitis B virus (HBV) infection on fatty liver disease is unclear..

Objectives: The aim of this study was to investigate the viral and host causes of fatty liver in chronic hepatitis B (CHB) patients. This study included 88 CHB patients of which 17 were not treated. Liver  biopsy was performed in each patient. Group 1 included those with hepatic steatosis (n=28) and group 2 those without hepatic steatosis. The groups were compared in terms of age, body mass index (BMI), Homeostasis Model Assessment- Insulin Resistance (HOMA-IR), viral load, biochemical parameters and histological findings. Patients in group 1 were subdivided according to the degree of steatosis as follows: grade 1 (15 patients, 53.6%), grade 2 (6 patients, 21.4%),and grade 3 (7 patients, 25%).

Results: In group 1 (n=28), mean age, BMI, cholesterol, and HOMA-IR were found to be significantly higher than in group 2 (n=60). There were no significant differences in the positivity of viral load, HbeAg, treatment, fibrosis and other laboratory parameters between the two groups. HOMA-IR was the only independent predictive factor of liver steatosis in patients with CHB in logistic regression analysis.
Conclusion: Hepatic steatosis in CHB patients was associated with host metabolic factors.

Keywords: Chronic hepatitis B, liver steatosis, HOMA-IR, BMI, biopsy