Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2024; 12(25): 5749-5760
Published online Sep 6, 2024. doi: 10.12998/wjcc.v12.i25.5749
Prevalence of nonalcoholic fatty liver disease in patients with hepatitis B: A meta-analysis
Li Zhang, Hong-Di Wu, Yuan-Fang Qian, Hong-Yan Xu
Li Zhang, Hong-Di Wu, Department of Infectious Diseases, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
Yuan-Fang Qian, Hong-Yan Xu, Department of Nursing, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang Province, China
Author contributions: Zhang L was responsible for conceptualization, formal analysis, investigation, writing, review and editing; Wu HD was responsible for methodology; Qian YF was responsible for writing of original draft preparation, and funding acquisition; Xu HY was responsible for resources and supervision; all authors commented on previous versions of the manuscript; all authors read and approved the final manuscript.
Supported by Program of Zhejiang Provincial TCM Sci-tech Plan, No. 2024ZL039.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Yan Xu, BMed, Associate Chief Nurse, Department of Nursing, Tongde Hospital of Zhejiang Province, No. 234 Gucui Road, Hangzhou 310012, Zhejiang Province, China. 13606617725@163.com
Received: May 21, 2024
Revised: June 27, 2024
Accepted: July 3, 2024
Published online: September 6, 2024
Processing time: 56 Days and 16.1 Hours
Abstract
BACKGROUND

The prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with chronic hepatitis B (CHB) has increased in recent clinical practice; however, the relationship between CHB and hepatic steatosis (HS) remains controversial.

AIM

To shed light on the potential association between NAFLD and hepatitis B virus (HBV) infection.

METHODS

We conducted a systematic literature search using multiple databases, including PubMed, the Cochrane Library, Web of Science, and EMBASE, to identify relevant studies. Predefined inclusion criteria were used to determine the eligibility of the studies for further analysis.

RESULTS

Comprehensive meta-analysis software was used for statistical analysis, which covered 20 studies. The results indicated a lower NAFLD susceptibility in HBV-infected individuals (pooled OR = 0.87; 95%CI = 0.69-1.08; I2 = 91.1%), with diabetes (P = 0.015), body mass index (BMI; P = 0.010), and possibly age (P = 0.061) as heterogeneity sources. Of note, in four studies (6197 HBV patients), HBV-infected individuals had a reduced NAFLD risk (OR = 0.68, 95%CI = 0.51-0.89, P = 0.006). A positive link between hyperlipidemia and metabolic syndrome emerged in hepatitis B patients, along with specific biochemical indicators, including BMI, creatinine, uric acid, fasting blood glucose, and homeostasis model assessment of insulin resistance.

CONCLUSION

HBV infection may provide protection against HS; however, the occurrence of HS in patients with HBV infection is associated with metabolic syndrome and specific biochemical parameters.

Keywords: Nonalcoholic fatty liver disease; Hepatitis B; Prevalence; Meta-analysis; Infectious

Core Tip: Investigating chronic hepatitis B (CHB) and nonalcoholic fatty liver disease (NAFLD) was reviewed in 20 studies. The results suggest reduced NAFLD susceptibility in hepatitis B virus (HBV)-infected individuals (OR = 0.87, 95%CI = 0.69-1.08, I2 = 91.1%). In HBV patients, a positive correlation emerged between hyperlipidemia, metabolic syndrome, and indicators, such as body mass index, creatinine, uric acid, fasting blood glucose, and homeostasis model assessment of insulin resistance. HBV may protect from hepatic steatosis, but its occurrence is associated with metabolic syndrome and specific factors. This study describes the complex interplay between CHB, NAFLD, and its associated factors.