Clinical Research
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Mar 28, 2007; 13(12): 1805-1810
Published online Mar 28, 2007. doi: 10.3748/wjg.v13.i12.1805
Sonographic fatty liver and hepatitis B virus carrier status: Synergistic effect on liver damage in Taiwanese adults
Yu-Cheng Lin, Shu-Tin Hsiao, Jong-Dar Chen
Yu-Cheng Lin, Jong-Dar Chen, Department of Family Medicine and Center for Environmental and Occupational Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, China
Shu-Tin Hsiao, Institute of Occupational Medicine Industrial Hygiene, National Taiwan University, Taipei, Taiwan, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Jong-Dar Chen, Department of Family Medicine and Center for Environmental and Occupational Medicine, Shin Kong Wu Ho-Su Memorial Hospital, 95, Wen Chang Road, Shih Lin, Taipei 111, Taiwan, China. jdarchen@ms28.hinet.net
Telephone: +886-2-28332211-2626 Fax: +886-2-28389420
Received: December 8, 2006
Revised: December 13, 2006
Accepted: January 17, 2007
Published online: March 28, 2007
Abstract

AIM: To examine the epidemiology of hepatitis B virus carrier status (HBVC) and sonographic fatty liver (SFL) in Taiwanese adults, and to evaluate their possible interaction in inducing liver damage (LD). From an epidemiological viewpoint, we analyzed previous studies which indicated that fatty liver sensitizes host immune response to HBV infection and enhances liver damage.

METHODS: A cross-sectional retrospective analysis of health records including medical history, physical examination, abdominal sonogram, blood biochemistry and hepatic virological tests. We utilized the Student’s t-test, chi-square, multivariate logistic regression and synergy index to assess risks for LD.

RESULTS: Among a total of 5406 Taiwanese adults (mean age 46.2 years, 51.5% males), the prevalence of LD, HBVC and SFL were 12.3%, 15.1% and 33.4%, respectively; 5.1% of participants had SFL plus HBVC. Multivariate logistic regression analysis demonstrated that male gender (odds ratio (OR) = 2.8, 95% confidence interval (CI): 2.3-3.5), overweight state (OR = 1.6, 95% CI: 1.3-2.0), HBVC (OR = 2.5, 95% CI: 2.0-3.1) and SFL (OR = 4.2, 95% CI: 2.2-5.3) were independently associated with LD. Synergism analysis showed that the adjusted OR for LD in adults with HBVC-alone was 3.3 (95% CI: 2.4-4.6), SFL-alone, 4.7 (95% CI: 3.7-6.1) and combined HBVC and SFL, 9.5 (95% CI: 6.8-13.3); the synergy index was 1.4 (95% CI: 1.001-2.0).

CONCLUSION: In Taiwanese adults, SFL plus HBVC have a significant synergistic association with LD.

Keywords: Fatty liver; Hepatitis B virus; Sonography; Synergism