Klinik Araştırma
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Kronik Hepatit B Etyolojili Kronik Karaciğer Hastalığında Obezite Bazlı Metabolik Profile Göre Non-invaziv Biyokimyasal Fibrozis Belirteçlerinin Karşılaştırılması

Yıl 2024, Cilt: 2 Sayı: 3, 113 - 116, 30.10.2024
https://doi.org/10.61845/agrimedical.1562045

Öz

Amaç: Bu çalışmanın amacı, obez ve obez olmayan Kronik Hepatit B (KHB) hastalarında fibrozis belirteçlerini karşılaştırarak obezitenin fibroz üzerindeki etkisini araştırmaktır.
Gereç ve Yöntem: Bu çalışmaya toplam 172 KHB'li (ortalama yaşı 50,6 ± 9,4 olan) hasta dahil edildi. Hastalar iki gruba ayrıldı: Obez (n=72) ve Obez Olmayan (n=100). Dahil etme kriterlerini kronik hepatit B tanısı almış ve ≤ 50 IU/mL veya saptanamayan HBV-DNA'sı olanlar, dışlama kriterlerini ise CHB dışında diğer kronik hastalık ve gebelik oluşturmaktaydı. Boy, vücut ağırlığı ve bel çevreleri ölçüldü. BKİ ≥30 kg/m2 obez olarak sınıflandırıldı. Alanin Aminotransferaz (ALT), Aspartat Aminotransferaz (AST), Gama glutamil transferaz, albümin, bilirubin ve protrombin zamanı analiz edildi. Fibrozis-4 skoru (FIB-4), Yaş x AST / trombosit sayısı x √(ALT) formülüyle hesaplandı ve AST-Trombosit Oranı İndeksi (APRI), [AST/AST (normalin üst sınırı)]/trombosit sayısı formülüyle hesaplandı.
Bulgular: AST obez hastalarda anlamlı olarak daha yüksekti (p<0.001). FIB-4 (p=0.002) ve APRI (p=0.007) skorları obez grupta daha yüksekti. Karaciğerin sağ lobunun uzunluğu obez grupta anlamlı şekilde fazlaydı (p=0.035).
Sonuç: Obezite, KHB hastalarında artmış fibrozis progresyonuyla ilişkilidir.Bu bulgular, obezitenin KHB hastalarında karaciğer hasarını şiddetlendirebileceğini ve fibrozis ilerlemesini yavaşlatmak için bu popülasyonda obezitenin tedavisinin önemini vurgulamaktadır. Obezitenin fibrozis üzerindeki etkisini hafifletmeye yönelik tedavi stratejilerini yönetmek için daha fazla araştırmaya ihtiyaç vardır.

Kaynakça

  • 1. Sheena BS, Hiebert L, Han H, et al. Global, regional, and national burden of hepatitis B, 1990– 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol. 2022;7(9):796-829.
  • 2. Trépo C, Chan HL, Lok A. Hepatitis B virus infection. Lancet. 2014; 6;384(9959):2053-63.
  • 3. Huang SC, Liu CJ. Chronic hepatitis B with concurrent metabolic dysfunction-associated fatty liver disease: Challenges and perspectives. Clin Mol Hepatol. 2023;29(2):320-31.
  • 4. Lingvay I, Cohen RV, Roux CWL, Sumithran P. Obesity in adults. The Lancet. 2024;404(10456):972-87.
  • 5. Wong GL ‐H., Chan HL ‐Y., Yu Z, et al. Coincidental metabolic syndrome increases the risk of liver fibrosis progression in patients with chronic hepatitis B – a prospective cohort study with paired transient elastography examinations. Aliment Pharmacol Ther. 2014;39(8):883-93.
  • 6. Lee J, Vali Y, Boursier J, et al. Prognostic accuracy of FIB‐4, NAFLD fibrosis score and APRI for NAFLD‐related events: A systematic review. Liver Int.2021;41(2):261-70.
  • 7. Blanco-Grau A, Gabriel-Medina P, Rodriguez-Algarra F, et al. Assessing Liver Fibrosis Using the FIB4 Index in the Community Setting. Diagnostics. 2021;11(12):2236.
  • 8. Saadeh S, Younossi ZM, Remer EM et. al. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology, 2002; 123(3):745-750.
  • 9. Petersen JR, Stevenson HL, Kasturi KS, et al. Evaluation of the aspartate aminotransferase/ platelet ratio index and enhanced liver fibrosis tests to detect significant fibrosis due to chronic hepatitis C. J Clin Gastroenterol. 2014;48(4):370-376.
  • 10. Medhioub M. Performance des scores FIB4 et APRI dans l’évaluation de la fibrose au cours de l’infection virale B chronique Performance of FIB4 and APRI scores for the prediction of fibrosis in patients with chronic hepatitis B virus infection. Tunis Med. 2020;98.
  • 11. Sun J, Li Y, Sun X, Liu Y, Zheng D, Fan L. Association between abdominal obesity and liver steatosis and fibrosis among patients with chronic hepatitis B measured by Fibroscan. Exp Ther Med. 2019;18(3):1891-98.
  • 12. Sefa Sayar M, Bulut D, Acar A. Evaluation of hepatosteatosis in patients with chronic hepatitis B virus infection. Arab J Gastroenterol. 2023;24(1):11-15.
  • 13. Cichoż-Lach H. Oxidative stress as a crucial factor in liver diseases. World J Gastroenterol. 2014;20(25):8082-91.
  • 14. Woreta TA, Alqahtani SA. Evaluation of Abnormal Liver Tests. Med Clin North Am. 2014;98(1):1-16.
  • 15. Kawamoto R, Kikuchi A, Akase T, , et al. Total bilirubin independently predicts incident metabolic syndrome among community-dwelling women. Diabetes Metab Syndr Clin Res Rev. 2019;13(2):1329-34.
  • 16. Kang SJ, Lee C, Kruzliak P. Effects of serum bilirubin on atherosclerotic processes. Ann Med. 2014;46(3):138-47.
  • 17. Younossi ZM, Golabi P, De Avila L, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A systematic review and meta-analysis. J Hepatol. 2019;71(4):793-801.

Comparison of Non-invasive Biochemical Fibrosis Markers According to Obesity-Based Metabolic Profile in Chronic Liver Disease with Chronic Hepatitis B Etiology

Yıl 2024, Cilt: 2 Sayı: 3, 113 - 116, 30.10.2024
https://doi.org/10.61845/agrimedical.1562045

Öz

Aim: The aim of this study is to investigate the impact of obesity on fibrosis by comparing fibrosis markers between obese and non-obese patients with Chronic Hepatitis B (CHB).
Material and Method: A total of 172 CHB (50.6±9.4 mean aged) patients were included in this retrospective study. The patients were divided into two groups: Obese (n=72) and Non-obese (n=100). Inclusion criteria were those diagnosed with chronic hepatitis B and ≤ 50 IU/mL or undetectable HBV-DNA, and exclusion criteria were other chronic diseases other than CHB and pregnancy. The height, body weight, and waist circumferences were measured. BMI ≥30 kg/m2 was classified as the obese group. Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), Gamma-glutamyl transferase, albumin, bilirubin, and prothrombin time were analyzed. Fibrosis-4 score (FIB-4) was calculated with the formula Age x AST / platelet count x √(ALT), and AST-Platelet Ratio Index (APRI) was calculated with the formula [AST/AST (upper limit of normal)]/ platelet count.
Results: AST levels were significantly higher in obese patients (p<0.001). FIB-4 (p=0.002) and APRI (p=0.007) scores were higher in the obese group. The length of the right lobe of the liver was also significantly enlarged in the obese group (p=0.035).
Conclusion: Obesity is associated withz increased fibrosis progression in CHB patients. These findings suggest that obesity may exacerbate liver damage in CHB patients and highlight the importance of managing obesity in this population to slow fibrosis progression. Further research is warranted to manage therapeutic strategies to mitigate the impact of obesity on fibrosis in CHB.

Etik Beyan

The study was approved by the Erzurum Health Science University Local Ethics Committee (Decision KAEK 2024/08-152, 14.08.2024).

Destekleyen Kurum

Erzurum Training and Research Hospital

Kaynakça

  • 1. Sheena BS, Hiebert L, Han H, et al. Global, regional, and national burden of hepatitis B, 1990– 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol. 2022;7(9):796-829.
  • 2. Trépo C, Chan HL, Lok A. Hepatitis B virus infection. Lancet. 2014; 6;384(9959):2053-63.
  • 3. Huang SC, Liu CJ. Chronic hepatitis B with concurrent metabolic dysfunction-associated fatty liver disease: Challenges and perspectives. Clin Mol Hepatol. 2023;29(2):320-31.
  • 4. Lingvay I, Cohen RV, Roux CWL, Sumithran P. Obesity in adults. The Lancet. 2024;404(10456):972-87.
  • 5. Wong GL ‐H., Chan HL ‐Y., Yu Z, et al. Coincidental metabolic syndrome increases the risk of liver fibrosis progression in patients with chronic hepatitis B – a prospective cohort study with paired transient elastography examinations. Aliment Pharmacol Ther. 2014;39(8):883-93.
  • 6. Lee J, Vali Y, Boursier J, et al. Prognostic accuracy of FIB‐4, NAFLD fibrosis score and APRI for NAFLD‐related events: A systematic review. Liver Int.2021;41(2):261-70.
  • 7. Blanco-Grau A, Gabriel-Medina P, Rodriguez-Algarra F, et al. Assessing Liver Fibrosis Using the FIB4 Index in the Community Setting. Diagnostics. 2021;11(12):2236.
  • 8. Saadeh S, Younossi ZM, Remer EM et. al. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology, 2002; 123(3):745-750.
  • 9. Petersen JR, Stevenson HL, Kasturi KS, et al. Evaluation of the aspartate aminotransferase/ platelet ratio index and enhanced liver fibrosis tests to detect significant fibrosis due to chronic hepatitis C. J Clin Gastroenterol. 2014;48(4):370-376.
  • 10. Medhioub M. Performance des scores FIB4 et APRI dans l’évaluation de la fibrose au cours de l’infection virale B chronique Performance of FIB4 and APRI scores for the prediction of fibrosis in patients with chronic hepatitis B virus infection. Tunis Med. 2020;98.
  • 11. Sun J, Li Y, Sun X, Liu Y, Zheng D, Fan L. Association between abdominal obesity and liver steatosis and fibrosis among patients with chronic hepatitis B measured by Fibroscan. Exp Ther Med. 2019;18(3):1891-98.
  • 12. Sefa Sayar M, Bulut D, Acar A. Evaluation of hepatosteatosis in patients with chronic hepatitis B virus infection. Arab J Gastroenterol. 2023;24(1):11-15.
  • 13. Cichoż-Lach H. Oxidative stress as a crucial factor in liver diseases. World J Gastroenterol. 2014;20(25):8082-91.
  • 14. Woreta TA, Alqahtani SA. Evaluation of Abnormal Liver Tests. Med Clin North Am. 2014;98(1):1-16.
  • 15. Kawamoto R, Kikuchi A, Akase T, , et al. Total bilirubin independently predicts incident metabolic syndrome among community-dwelling women. Diabetes Metab Syndr Clin Res Rev. 2019;13(2):1329-34.
  • 16. Kang SJ, Lee C, Kruzliak P. Effects of serum bilirubin on atherosclerotic processes. Ann Med. 2014;46(3):138-47.
  • 17. Younossi ZM, Golabi P, De Avila L, et al. The global epidemiology of NAFLD and NASH in patients with type 2 diabetes: A systematic review and meta-analysis. J Hepatol. 2019;71(4):793-801.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Gastroenteroloji ve Hepatoloji
Bölüm Araştırma Makalesi
Yazarlar

Sedat Çiftel 0000-0003-4905-1944

Yayımlanma Tarihi 30 Ekim 2024
Gönderilme Tarihi 6 Ekim 2024
Kabul Tarihi 25 Ekim 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 2 Sayı: 3

Kaynak Göster

AMA Çiftel S. Comparison of Non-invasive Biochemical Fibrosis Markers According to Obesity-Based Metabolic Profile in Chronic Liver Disease with Chronic Hepatitis B Etiology. Ağrı Med J. Ekim 2024;2(3):113-116. doi:10.61845/agrimedical.1562045