The clinical and pathological features of hepatic steatosis in patients with chronic hepatitis B based on a matched case-control study

Objective To study the clinical and pathological features of hepatic steatosis in patients with chronic hepatitis B (CHB) based on a matched case-control study. Methods Cross-sectional study was carried out on CHB patients who received liver biopsy in the Department of Infectious Diseases, Shunde First People's Hospital from January 2006 to December 2014.Clinical data of the patients were collected. A total of 216 matched pairs were created according to gender and age. The clinical and pathological feathers of both groups were compared and analyzed. Quantitative data with normal distribution were compared by t test and those with abnormal distribution were compared by nonparametric rank sum test of two- or multi-independent samples. Categorical data were compared by χ2 test. Results In matched pairs, rates of overweight/obesity were 84.2% in fatty liver group and 18.5% in non-fatty liver group (χ2=189.30, P=0.001), patients with high cholesterol in the two groups were 30.6% and 13.4%, respectively (χ2=18.47, P=0.001), high triglycerides were 27.3% and 9.7%, respectively (χ2=22.15, P=0.001), high low-density lipoprotein were 16.7% and 5.6%, respectively (χ2=13.50, P=0.001), high uric acid were 31.0% and 15.3%, respectively (χ2=15.04, P=0.001) and rates of alcohol history were 38.9% and 25.9%, respectively (χ2=8.08, P=0.001). The differences of hepatitis B virus (HBV) DNA and status of hepatitis B e antigen between the two groups were not statistically significant (both P>0.05). Compared to fatty liver group, rates of hepatic inflammation activity degree ≥3 (54.6% vs 37.5%, χ2=12.75, P<0.01) and fibrosis staging ≥3 (53.2% vs 41.7%, χ2=5.80, P=0.016) in non-fatty liver group were both significantly higher. Conclusions CHB patients with overweight/obesity, high cholesterol, high triglycerides, high low-density lipoprotein, high uric acid and drinking history are more likely to develop hepatic steatosis. The inflammatory grade and fibrosis stage in non-fatty liver group are more serious than those in fatty liver group. Key words: Hepatitis B; Fatty liver; Inflammation; Fibrosis; Case-control studies; Influential factor