Association Between Metabolic Dysfunction-Associated Fatty Liver Disease and the Risk of Cirrhosis in Patients with Chronic Hepatitis B-A Retrospective Cohort Study

Qing-Xia Wang; Jiao Xue; Mei-Jie Shi; Yu-Bao Xie; Huan-Ming Xiao; Sheng Li; Ming Lin; Xiao-Ling Chi

doi:10.2147/DMSO.S369824

Association Between Metabolic Dysfunction-Associated Fatty Liver Disease and the Risk of Cirrhosis in Patients with Chronic Hepatitis B-A Retrospective Cohort Study

Diabetes Metab Syndr Obes. 2022 Aug 2:15:2311-2322. doi: 10.2147/DMSO.S369824. eCollection 2022.

Authors

Qing-Xia Wang¹, Jiao Xue¹, Mei-Jie Shi², Yu-Bao Xie², Huan-Ming Xiao², Sheng Li², Ming Lin², Xiao-Ling Chi²

Affiliations

¹ The Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, People's Republic of China.
² Department of Hepatology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, People's Republic of China.

Abstract

Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is a novel proposed concept that is being recognized worldwide. Both chronic hepatitis B (CHB) and MAFLD have been independently attributed to an increased risk of disease development to cirrhosis. However, it is still unclear whether MAFLD is associated with an increased risk of cirrhosis in CHB patients.

Aim: This study aimed to analyze the impact of MAFLD on the risk of cirrhosis in CHB patients.

Methods: In this retrospective cohort study, consecutive CHB patients with or without MAFLD were enrolled from January 1st, 2007, to May 1st, 2020, in Guangdong Provincial Hospital of Chinese Medicine. Inverse probability treatment weighting (IPTW) was performed to balance the covariates across groups. The weighted Kaplan-Meier analysis and Cox regression analysis were used to compare both groups for the risk of cirrhosis.

Results: A total of 1223 CHB patients were included in this study during the median follow-up of 5.25 years; of these patients, 355 were CHB-MAFLD patients. After IPTW, the weighted Kaplan-Meier analysis showed that the weighted cumulative incidence of cirrhosis was significantly higher in patients with MAFLD than that in patients without MAFLD (12.6% versus 7.1%, P=0.015). In the weighted multivariate Cox analysis, coexisting MAFLD was related to an increased risk of cirrhosis [adjusted weighted hazard ratio (HR) 1.790; P =0.020]. Age (>40 years, adjusted weighted HR, 1.950; P=0.015), diabetes mellitus (adjusted weighted HR, 1.883; P=0.041), non-antiviral treatment (adjusted weighted HR, 2.037; P=0.013), and baseline serum HBV DNA levels (>2.4 log¹⁰ IU/mL, adjusted weighted HR, 1.756; P=0.045) were significant risk factors for cirrhosis.

Conclusion: We found that MAFLD was associated with a higher risk of cirrhosis in CHB patients.

Keywords: chronic hepatitis B; cirrhosis; hepatic steatosis; metabolic dysfunction-associated fatty liver disease.

Grants and funding

The present study was funded by the Thirteen Five-Year Plan for Major and Special Program of the National Science and Technology of China (2018ZX10725506-003 and 2018ZX10725505-004); the biological resources project collaborated by Guangdong Provincial Hospital of Chinese Medicine and Shanghai chip National Engineering Center (YN2016XP03), the Science and Technology research project of Traditional Chinese Medicine of Guangdong Provincial Hospital of Chinese Medicine(YN2021DB07), and the Clinical research projects of Guangdong Provincial Hospital of Chinese Medicine (YN10101903).