Evaluation nutritional status and anthropometric parameters in patients with chronic hepatitis B

Abstract

Introduction: Hepatitis B continues to be a major health problem around the world. 257 million people are estimated to be chronically infected with hepatitis B worldwide. Chronic hepatitis B (CHB) patients are likely to develop various comorbidities, including diabetes, insulin resistance, hyperlipidemia, nonalcoholic fatty liver disease, and obesity. Proper nutrition is essential for the management of both hepatitis B and its associated comorbidities. Material and Method: The study was completed a total of 105 patients. The universe of the study comprised of CHB patients who were admitted to the nutrition and dietetics outpatient clinic of a public hospital in Turkey between 1 October 2019 and 31 December 2019. Biochemical and ultrasound results, anthropometric measures, demographic characteristics, dietary habits, and 1-day food records were retrospectively recorded from patient files. Results: Female patients were more likely to consume 2 main meals per day (57.8%) whereas most male subjects (75.6%) consumed 3 meals. Both female and male patients had above-normal Body Mass Index (BMI) (31.2 kg/m2 and 29.2 kg/m2, respectively), and they also had high dietary fat (%) and cholesterol consumption than recommendation. In addition, males had borderline The fasting blood glucose (FBG), total cholesterol, and triglyceride levels, and both sexes were at risk for abdominal obesity. Dietary carbohydrate, fiber, B1, B6, calcium, magnesium, and phosphorus intake were higher in males than in females. Conclusion: This study was found on above-normal BMI values, and high dietary fat (%), and cholesterol consumption in both males and females. Moreover, males had borderline FBG, total cholesterol, and triglyceride levels, and both sexes were at risk for abdominal obesity. In the setting of CHB, it is crucial to maintain an adequate and balanced diet to control body weight, prevent nutritional disorders, protect the liver, and improve overall well-being. More comprehensive studies are needed to better understand the link between nutrition and hepatitis B.

Keywords

• Chronic hepatitis B virus infection
• nutritional status
• body composition
• body weights and measures

References

1. European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatology 2017; 67: 370-98.
2. World Health Organization. Global hepatitis report 2017. https://apps.who.int/iris/handle/10665/255016. License: CC BY-NC-SA 3.0 IGO. Accessed date: 17.05.2021.
3. Gerlich WH. Medical virology of hepatitis B: how it began and where we are now. Virol J 2013; 10: 1-25.
4. Toy M, Onder FO, Wormann T, et al. Age- and region-specific hepatitis B prevalence in Turkey estimated using generalized linear mixed models: a systematic review. BMC Infect Dis 2011; 11: 337.
5. Krajden M, McNabb G, Petric M. The laboratory diagnosis of hepatitis B virus. Can J Infect Dis Med Microbiol 2005; 16: 65-72.
6. Lee I-C, Huang Y-H, Chan C-C, et al. Impact of body mass index and viral load on liver histology in hepatitis B e antigen-negative chronic hepatitis B. Clin Nutr 2011; 30: 647-52.
7. Silva M, Gomes S, Peixoto A, et al. Nutrition in Chronic Liver Disease. GE Port J Gastroenterol 2015; 22: 268-76.
8. World Health Organization Europe, 2018. Body mass index-BMI. http://www. euro. who. int/en/health-topics/diseaseprevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. Accessed date: 03.08.2021.

9. World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8-11 December 2008. https://apps.who.int/iris/handle/10665/44583. Accessed date: 03.08.2021.
10. International Physical Activity Questionnaire. IPAQ scor-ing protocol, 2005. https://www.physio-pedia.com/images/c/c7/Quidelines_for_interpreting_the_IPAQ.pdf. Accessed date: 03.08.2021.
11. Shafiq M, Nadeem M, Sattar Z, et al. Identification of risk factors for hepatitis B and C in Peshawar, Pakistan. HIV/AIDS (Auckl) 2015; 7: 223-31.
12. Hashimoto M, Tashiro H, Kobayashi T, Kuroda S, Hamaoka M, Ohdan H. Influence of higher BMI for hepatitis B-and C-related hepatocellular carcinomas. Langenbecks Arch Surg 2017; 402: 745-55.
13. Ferolla SM, Ferrari TC, Lima ML, et al. Dietary patterns in Brazilian patients with nonalcoholic fatty liver disease: a cross-sectional study. Clinics (Sao Paulo) 2013; 68: 11-7.
14. Peng D, Han Y, Ding H, Wei L. Hepatic steatosis in chronic hepatitis B patients is associated with metabolic factors more than viral factors. J Gastroenterol Hepatol 2008; 23: 1082-8.
15. Wong VW-S, Wong GL-H, Chu WC-W, et al. Hepatitis B virus infection and fatty liver in the general population. J Hepatol 2012; 56: 533-40.
16. Quaye O, Amuzu BG, Adadey SM, Tagoe EA. Effect of hepatitis B virus (HBV) infection on lipid profile in Ghanaian patients. Virology (Auckl) 2019; 10: 1178122X19827606.
17. Turkey nutrition and health survey 2010: Evaluation of nutritional status and habits, final report. Minister of Health 2014. https://hsgm.saglik.gov.tr/depo/birimler/saglikli-beslenme-hareketli-hayat-db/Yayinlar/kitaplar/diger-kitaplar/TBSA-Beslenme-Yayini.pdf. Accessed date: 19.05.2021
18. Schillie S, Xing J, Murphy T, Hu D. Prevalence of hepatitis B virus infection among persons with diagnosed diabetes mellitus in the United States, 1999–2010. J Viral Hepat 2012; 19: 674-6.
19. Cai C, Zeng J, Wu H, et al. Association between hepatitis B virus infection and diabetes mellitus: A meta-analysis. Exp Ther Med 2015; 10: 693-8.
20. Pekcan G, Şanlıer N, Baş M, et al. Turkey nutrition guide. 2015. https://dosyasb.saglik.gov.tr/Eklenti/10915,tuber-turkiye-beslenme-rehberipdf.pdf. Accessed date: 19.05.2021.
21. Hallsworth K, Thoma C, Moore S, et al. Non-alcoholic fatty liver disease is associated with higher levels of objectively measured sedentary behaviour and lower levels of physical activity than matched healthy controls. Frontline Gastroenterol 2015; 6: 44-51.
22. Loprinzi PD, VanWagner LB. Survival effects of physical activity on mortality among persons with liver disease. Prev Med Rep 2016; 3: 132-4.