Metabolic dysfunction-associated fatty liver and antiviral response in chronic hepatitis B: A systematic review and meta-analysis

Table 1 Characteristics and methodological quality of studies included in the meta-analysis, mean ± SD

Ref.	Study	Country	Sample size	Age		MAFLD diagnostics	Medication	Male		Female		NOS score
				CHB	CHB + MAFLD			CHB	CHB + MAFLD	CHB	CHB + MAFLD
Yendewa et al[8], 2025	RCS	United States	25460	53.90 ± 15.00	53.40 ± 13.10	Radiological	NAs	7599	7338	5006	5218	8
Yang et al[9], 2025	RCS	China	186	38.06 ± 12.76	-	Liver biopsy	NAs	85	57	33	11	8
Ren et al[10], 2025	RCS	China	320	46.21 ± 11.43	45.57 ± 10.61	FibroScan	NAs + PEG-IFN	106	76	89	49	8
Li et al[11], 2025	RCS	China	158	40.00 ± 8.00	39.00 ± 8.00	Ultrasound or FibroScan	NAs + PEG-IFN	75	60	16	7	8
Chau et al[12], 2025	RCS	A large international cohort	1736	49.50 ± 13.00	49.60 ± 12.00	Radiological	NAs	586	581	282	287	8
Li et al[13], 2024	RCS	China	120	29.50 ± 5.60	31.00 ± 7.10	Ultrasound and elasticity	NAs	53	37	27	3	6
Huang et al[14], 2024	RCS	China	4084	48.00 ± 14.83	51.65 ± 11.14	Ultrasound	NAs + PEG-IFN	1605	594	1592	293	8
Chen et al[15], 2024	RCS	China	120	39.00 ± 11.10	41.70 ± 10.40	Liver biopsy	NAs	28	48	33	11	8
Zhang et al[16], 2023	RCS	China	267	38.05 ± 12.71	37.51 ± 10.75	Liver biopsy	NAs	111	75	53	28	7
Li et al[17], 2021	RCS	United States and China	2158	49.69 ± 10.01	49.68 ± 9.13	Ultrasound or CT	NAs	768	763	311	316	8
Liang et al[18], 2020	PCS	China	226	29.50 ± 5.47	-	Liver biopsy	PEG-IFN-2a	82	95	37	12	6
Li et al[19], 2020	RCS	United States	555	45.50 ± 14.60	47.70 ± 12.50	Imaging or histology	NAs	211	126	157	61	7
Chen et al[20], 2020	RCS	China	196	36.20 ± 10.80	42.70 ± 10.80	Liver biopsy	NAs	61	81	33	21	8
Kim et al[21], 2019	RCS	Korea	334	50.40 ± 10.24	49.70 ± 10.70	FibroScan	NAs	119	91	69	55	6
Zhu et al[22], 2016	RCS	China	125	39.61 ± 10.87	39.26 ± 10.39	Ultrasound	NAs	41	42	23	19	7
Liu et al[23], 2016	PCS	China	60	37.35 ± 8.49	37.70 ± 7.90	CT ratios of liver/spleen	NAs	12	23	8	17	6
Gong et al[24], 2015	PCS	China	89	25.10 ± 7.80	30.30 ± 7.40	Liver biopsy	PEG-IFN-2a	38	20	20	11	7
Karaman et al[25], 2013	RCS	Turkey	119	40.03 ± 13.80	43.80 ± 11.70	Liver biopsy	NAs	-	-	-	-	6
Jin et al[26], 2012	PCS	China	213	39.55 ± 7.83	39.56 ± 11.87	Ultrasound	NAs	85	32	63	33	8
Ateş et al[27], 2011	PCS	Turkey	84	35.20 ± 8.90	50.50 ± 8.70	Liver biopsy	PEG-IFN	46	14	19	5	6
Amano et al[28], 2025	RCS	Japan	164	-	-	According to the international expert consensus	NAs	-	-	-	-	6
Huang et al[29], 2023	RCS	China	10546	47.00 ± 14.83	52.00 ± 11.87	Ultrasound	NAs + PEG-IFN	3880	1505	4454	707	8
Yun et al[30], 2022	RCS	Korea	197346	53.30 ± 8.90	53.00 ± 8.90	Fatty liver index ≥ 30	NAs + PEG-IFN	60068	51335	71129	14814	7
Yu et al[31], 2022	PCS	China	1453	50.31 ± 9.46	50.33 ± 9.80	Ultrasound	NAs + PEG-IFN	-	-	-	-	7
Ko et al[32], 2022	CSS, RCS	Canada	1178	46.2 ± 1.64	-	Ultrasound	NAs + PEG-IFN	289	387	262	237	6
van Kleef et al[33], 2021	RCS	Canada, the Netherlands	1076	-	-	Liver biopsy	NAs + PEG-IFN	470	237	310	59	8
Mak et al[34], 2021	PCS	China	1914	55.95 ± 10.91	55.11 ± 11.73	FibroScan	NAs	559	563	398	394	8
Lim et al[35], 2020	RCS	Singapore	289	-	-	Liver biopsy	NAs + PEG-IFN	68	141	36	44	8
Choi et al[36], 2020	RCS	Canada, the Netherlands	1089	37.60 ± 13.00	43.90 ± 12.80	Liver biopsy	NAs + PEG-IFN	569	149	335	36	6
Cho et al[37], 2020	RCS	Korea	826	54.00 ± 8.80	52.00 ± 9.40	Ultrasound	NAs	333	171	233	89	8
Peleg et al[38], 2019	RCS	Israeli	524	42.80 ± 11.42	50.73 ± 10.87	Liver biopsy	NAs + PEG-IFN	173	142	110	99	8
Lee et al[39], 2019	RCS	Korea	321	40.30 ± 11.93	43.94 ± 11.35	Liver biopsy	NAs	146	50	105	20	8

PCS: Prospective cohort study; RCS: Retrospective cohort study; CSS: Cross-sectional study; CHB: Chronic hepatitis B; MAFLD: Metabolic dysfunction-associated fatty liver disease; NAs: Nucleos(t)ide analogues; PEG-IFN: Pegylated interferon; NOS: Newcastle-Ottawa Scale; CT: Computed tomography.