Background: Chronic infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) is a major cause of liver cirrhosis and hepatocellular carcinoma worldwide, and is also associated with a wide range of extrahepatic manifestations affecting multiple organ systems. However, comparative studies on the prevalence, risk factors, and clinical associations of these extrahepatic manifestations in Mongolia remain limited. Aim: To comparatively evaluate the risk factors and clinical associations of selected extrahepatic manifestations in patients with chronic HBV and HCV infections. Materials and Methods: This retrospective cohort study included a total of 1.040 participants matched by age and sex. Extrahepatic manifestations were assessed, including hypertension, hyperglycemia, dyslipidemia, and impaired renal function. Results: Extrahepatic manifestations such as hypertension, hyperglycemia, dyslipidemia, and renal dysfunction were significantly more prevalent in the chronic HCV group (p<0.05). In contrast, obesity was more common in the chronic HBV group, particularly among males aged 50-59 years. Increasing age (OR=1.04, 95% CI: 1.02-1.06) and chronic HCV infection (OR=1.65, 95% CI: 1.20-2.26) were associated with a higher risk of extrahepatic manifestations. Liver fibrosis showed similarly high prevalence in both groups (71-72%), with the highest occurrence in the 50-59 age group. A moderate positive correlation was observed between fibrosis stage and renal function impairment (r=0.45). Conclusion Chronic HCV infection is more strongly associated with the presence and risk of extrahepatic manifestations compared to HBV. Age, sex, and metabolic abnormalities are important contributing risk factors. Therefore, regular monitoring of metabolic and renal function, in addition to liver disease, is essential in patients with chronic viral hepatitis to prevent complications.

Introduction: Cardiovascular disease-related mortality accounts for 34% globally, 23% in the United States, and 22% in Europe, with Asia representing 35% of total deaths as of 2019. In Asia, ischemic heart disease and stroke are the most common causes of cardiovascular diseases (CVD), and the prevalence of these two types of CVD varies significantly across different regions and countries in Asia. Over the last 10 years, the average number of deaths due to cardiovascular diseases has been 5.7 thousand annually, representing 33.7% of total mortality. Cardiovascular diseases account for 11.1% of all illnesses, and as of 2021, the rate has increased by 128 compared to the average of the past 10 years, reaching 936 per 10.000 population. As cardiovascular disease-related mortality is the leading cause of death worldwide, every country has criteria for calculating the 10-year risk of CVD to reduce cardiovascular morbidity and mortality. These criteria are crucial for predicting the risk of stroke and cardiovascular diseases in individuals with or without diabetes. Purpose: To assess the risk of heart disease in people aged 40-74 years without cardiovascular disease. Material and Methods: A total of 394 individuals aged 40-74 were included in the study. Blood samples were taken to determine lipid profiles and fasting glucose levels. Using the World Health Organization's (2019) revised cardiovascular disease risk assessment model (which considers age, systolic blood pressure, smoking, total cholesterol, LDL and BMI), the 10-year risk of developing cardiovascular disease was calculated using both laboratory-based and non-laboratory based risk assessment criteria. Statistical analysis of the study was performed using SPSS 26 software, with a p-value of less than 0.05 considered statistically significant. Ethics: The methodology was approved by the Medical Ethics Sub-Committee of the Ach medical university on the 30th of June, 2023 (Decision #23/02/03) Result: The average age of the adults included in the study was 49.3±14.7 years. Among those aged 40-74 who participated in the CVD risk assessment criteria, the average age was 53.7±9 years, with men having an average age of 54.6±9.3 (117 participants) and women having an average age of 53±8.7 (223 participants). The total cardiovascular risk of the study participants was 54.8% very low, 15.7% low, 13.2% moderate, 8.1% high, and 8.1% very high according to laboratory-based assessment, while the non-laboratory based assessment showed 49% very low, 20.7% low, 16.8% moderate, 7.7% high and 5.9% very high risk).
Among all participants, the prevalence of cardiovascular risk factors was assessed as follows: 26.9% (95% CI: 22.6–31.6%) were smokers, 60.5% (95% CI: 55.4–65.3%) consumed alcohol, 46.4% (95% CI: 42.4–50.2%) had arterial hypertension, 10.4% (95% CI: 0.76–13.9%) had diabetes mellitus, 75% were obese, 78.4% (95% CI: 74.2–81.6%) had central obesity, 24.4% (95% CI: 18.5–31%) had hyperglycemia, 42.6% (95% CI: 35.6–49.9%) had hypercholesterolemia, 19.3% (95% CI: 14–25.5%) had hypertriglyceridemia, and 11.3% (95% CI: 0.71–16.7%) had elevated low-density lipoprotein levels.
The total cardiovascular risk of the study participants was 54.8% very low, 15.7% low, 13.2% moderate, 8.1% high, and 8.1% very high according to laboratory-based assessment, while the non-laboratory based assessment showed 49% very low, 20.7% low, 16.8% moderate, 7.7% high and 5.9% very high risk.
These distributions showed a statistically significant difference compared to the group without arterial hypertension (p<0.0001). Additionally, comparison of risk between individuals with and without diabetes mellitus using laboratory-based assessment also revealed a statistically significant difference (p<0.0001). The concordance between the two models was 88.8% (95% CI: 83.6–92.9) with a Cohen’s kappa coefficient of κ=0.6, indicating moderate agreement with statistically significant difference (p<0.001). Conclusion 75% of the people surveyed were obese and 78.4% had central obesity, with men at greater risk than women. The cardiovascular risk of having arterial hypertension and diabetes is further increased. The correlation coefficient of the risk estimates showed a strong correlation across gender and age groups. The agreement between the risk estimate models was 88.8%, or a moderate agreement with Cohen's coefficient (k=0.6).