Association between hepatic steatosis and the development of hepatocellular carcinoma in patients with chronic hepatitis B
- Author:
Yun Bin LEE
1
;
Yeonjung HA
;
Young Eun CHON
;
Mi Na KIM
;
Joo Ho LEE
;
Hana PARK
;
Kwang il KIM
;
Soo Hwan KIM
;
Kyu Sung RIM
;
Seong Gyu HWANG
Author Information
- Publication Type:Original Article
- Keywords: Hepatitis B virus; Fatty liver; Nonalcoholic fatty liver disease (NAFLD); Metabolic syndrome; Liver cancer
- MeSH: Biopsy; Carcinoma, Hepatocellular; Fatty Liver; Follow-Up Studies; Hepatitis B virus; Hepatitis B, Chronic; Hepatitis, Chronic; Humans; Incidence; Liver; Liver Neoplasms; Non-alcoholic Fatty Liver Disease; Propensity Score
- From:Clinical and Molecular Hepatology 2019;25(1):52-64
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Nonalcoholic fatty liver disease (NAFLD) is becoming a worldwide epidemic, and is frequently found in patients with chronic hepatitis B (CHB). We investigated the impact of histologically proven hepatic steatosis on the risk for hepatocellular carcinoma (HCC) in CHB patients without excessive alcohol intake. METHODS: Consecutive CHB patients who underwent liver biopsy from January 2007 to December 2015 were included. The association between hepatic steatosis (≥ 5%) and subsequent HCC risk was analyzed. Inverse probability weighting (IPW) using the propensity score was applied to adjust for differences in patient characteristics, including metabolic factors. RESULTS: Fatty liver was histologically proven in 70 patients (21.8%) among a total of 321 patients. During the median (interquartile range) follow-up of 5.3 (2.9–8.3) years, 17 of 321 patients (5.3%) developed HCC: 8 of 70 patients (11.4%) with fatty liver and 9 of 251 patients (3.6%) without fatty liver. The five-year cumulative incidences of HCC among patients without and with fatty liver were 1.9% and 8.2%, respectively (P=0.004). Coexisting fatty liver was associated with a higher risk for HCC (adjusted hazards ratio [HR], 3.005; 95% confidence interval [CI], 1.122–8.051; P=0.03). After balancing with IPW, HCC incidences were not significantly different between the groups (P=0.19), and the association between fatty liver and HCC was not significant (adjusted HR, 1.709; 95% CI, 0.404–7.228; P=0.47). CONCLUSIONS: Superimposed NAFLD was associated with a higher HCC risk in CHB patients. However, the association between steatosis per se and HCC risk was not evident after adjustment for metabolic factors.
