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Abstract：
BACKGROUND: The influence of chronic hepatitis B infection (CBI) on hepatic steatosis, necroinflammation, and fibrosis in nonalcoholic fatty liver disease (NAFLD) population was unclear. We aimed to investigate the effect of CBI on hepatic steatosis and assess the association between NAFLD co-existed CBI and hepatic injury in NAFLD pediatric population.
METHODS: Consecutive hospitalized children with biopsy-proven NAFLD with or without CBI were included. Hepatic steatosis, necroinflammation and fibrosis were evaluated by NASH CRN system and/or METAVIR scoring system, appropriately. Using multivariate logistic analysis, we identified variables associated with hepatic steatosis and liver injury.
RESULTS: Of 223 biopsy-proven NAFLD children, 161 were NAFLD without CBI, and 62 were NAFLD co-existed CBI. Grouped by mild, moderate and severe hepatic steatosis, there was an inverse association between CBI and the severity of hepatic steatosis [odd ratio (OR) 0.037, 95% confidence interval (CI) 0.014-0.098]. In addition, we explored the relationship between CBI and hepatic necroinflammation and fibrosis in NAFLD children. Hepatic necroinflammation and fibrosis, respectively, were divided into two groups according to severity. And CBI was positively associated with hepatic necroinflammation (OR 6.125, 95%CI 1.958-19.158). However, there was no statistically independent association between CBI and significant hepatic fibrosis.
CONCLUSIONS: CBI was inverse associated with the grade of steatosis and positively associated with severe hepatic necroinflammation, and does not appear to affect significant hepatic fibrosis in pediatric NAFLD children.
METHODS: Consecutive hospitalized children with biopsy-proven NAFLD with or without CBI were included. Hepatic steatosis, necroinflammation and fibrosis were evaluated by NASH CRN system and/or METAVIR scoring system, appropriately. Using multivariate logistic analysis, we identified variables associated with hepatic steatosis and liver injury.
RESULTS: Of 223 biopsy-proven NAFLD children, 161 were NAFLD without CBI, and 62 were NAFLD co-existed CBI. Grouped by mild, moderate and severe hepatic steatosis, there was an inverse association between CBI and the severity of hepatic steatosis [odd ratio (OR) 0.037, 95% confidence interval (CI) 0.014-0.098]. In addition, we explored the relationship between CBI and hepatic necroinflammation and fibrosis in NAFLD children. Hepatic necroinflammation and fibrosis, respectively, were divided into two groups according to severity. And CBI was positively associated with hepatic necroinflammation (OR 6.125, 95%CI 1.958-19.158). However, there was no statistically independent association between CBI and significant hepatic fibrosis.
CONCLUSIONS: CBI was inverse associated with the grade of steatosis and positively associated with severe hepatic necroinflammation, and does not appear to affect significant hepatic fibrosis in pediatric NAFLD children.
摘要：
背景：慢性乙型肝炎感染（CBI）对肝脏脂肪变性的影响，坏死性炎症,非酒精性脂肪性肝病（NAFLD）人群的纤维化尚不清楚。我们旨在研究CBI对肝脏脂肪变性的影响，并评估NAFLD儿科人群中同时存在的CBI和肝损伤之间的关联。
方法：纳入经活检证实的NAFLD伴或不伴CBI的连续住院儿童。肝脏脂肪变性,通过NASHCRN系统和/或METAVIR评分系统评估坏死和纤维化，适当。使用多变量逻辑分析，我们确定了与肝脂肪变性和肝损伤相关的变量.
结果：在223例经活检证实的NAFLD儿童中，161名没有CBI的NAFLD，62例NAFLD并存CBI。按轻度分组，中度和重度肝性脂肪变性，CBI与肝脏脂肪变性的严重程度呈负相关[奇数比(OR)0.037,95%置信区间(CI)0.014~0.098].此外,我们探讨了NAFLD儿童CBI与肝坏死性炎症和纤维化之间的关系.肝坏死性炎症和纤维化，分别,根据严重程度分为两组。CBI与肝坏死性炎症呈正相关（OR6.125，95CI1.958-19.158）。然而,CBI与显著肝纤维化之间无统计学独立关联.
结论：CBI与脂肪变性程度呈负相关，与严重肝坏死性炎症呈正相关，并且似乎不会影响小儿NAFLD儿童的显着肝纤维化。
方法：纳入经活检证实的NAFLD伴或不伴CBI的连续住院儿童。肝脏脂肪变性,通过NASHCRN系统和/或METAVIR评分系统评估坏死和纤维化，适当。使用多变量逻辑分析，我们确定了与肝脂肪变性和肝损伤相关的变量.
结果：在223例经活检证实的NAFLD儿童中，161名没有CBI的NAFLD，62例NAFLD并存CBI。按轻度分组，中度和重度肝性脂肪变性，CBI与肝脏脂肪变性的严重程度呈负相关[奇数比(OR)0.037,95%置信区间(CI)0.014~0.098].此外,我们探讨了NAFLD儿童CBI与肝坏死性炎症和纤维化之间的关系.肝坏死性炎症和纤维化，分别,根据严重程度分为两组。CBI与肝坏死性炎症呈正相关（OR6.125，95CI1.958-19.158）。然而,CBI与显著肝纤维化之间无统计学独立关联.
结论：CBI与脂肪变性程度呈负相关，与严重肝坏死性炎症呈正相关，并且似乎不会影响小儿NAFLD儿童的显着肝纤维化。
