PDF(Pubmed)
Abstract：
Hepatocellular carcinoma (HCC) remains an important complication in patients with chronic hepatitis B (CHB). An association between the presence of metabolic dysfunction-associated fatty liver disease (MAFLD) and an increased HCC risk in patients with CHB may exist; however, the exact nature of this possible association remains unclear. The present study conducted a comprehensive meta-analysis by pooling data from 18 studies encompassing 23,927 participants. The odds ratios (ORs) were calculated using a random-effects inverse-variance model, and heterogeneity was assessed using Cochran\'s Q test and the I² statistic. In addition, subgroup analyses were performed on the basis of geographical region, study design and follow-up length. Publication bias and meta-regression were also assessed. The overall pooled OR for the association between MAFLD and HCC risk in patients with CHB was 1.053 (95% CI, 0.704-1.576), which suggested a lack of association. Heterogeneity was observed across studies. Subgroup analyses demonstrated a potentially protective effect for MAFLD on the risk of HCC in patients in Asian countries (OR, 0.783; 95% CI, 0.568-1.080) and the opposite effect in other regions (OR, 4.380; 95% CI, 2.440-7.864). Analysis of the prospective cohort studies suggested a significant protective effect for MAFLD (OR, 0.479; 95% CI, 0.365-0.629), while analysis of retrospective cohorts did not. The publication bias assessment was inconclusive and the meta-regression failed to identify heterogeneity sources. The association between MAFLD and HCC risk in patients with CHB appeared to be multifactorial and may vary on the basis of geographical region and study design. While the exact mechanisms remain elusive, the potential protective effect demonstrated in certain subgroups warrants further investigation.
摘要：
肝细胞癌（HCC）仍然是慢性乙型肝炎（CHB）患者的重要并发症。代谢功能障碍相关的脂肪肝疾病（MAFLD）的存在与CHB患者的HCC风险增加之间的关联可能存在;然而，这种可能关联的确切性质尚不清楚.本研究通过汇集18项研究的数据进行了全面的荟萃分析，包括23,927名参与者。比值比(OR)使用随机效应逆方差模型计算，异质性使用科克伦Q检验和I²统计量进行评估。此外,亚组分析是根据地理区域进行的，研究设计和随访长度。还评估了发表偏倚和荟萃回归。CHB患者MAFLD和HCC风险之间的关联的总体合并OR为1.053（95％CI，0.704-1.576），这表明缺乏联系。在研究中观察到异质性。亚组分析显示MAFLD对亚洲国家患者HCC风险的潜在保护作用（OR，0.783；95%CI，0.568-1.080），其他区域的作用相反（OR，4.380；95%CI，2.440-7.864）。前瞻性队列研究的分析表明对MAFLD有显著的保护作用(OR，0.479；95%CI，0.365-0.629），而对回顾性队列的分析则没有。发表偏倚评估尚无定论，荟萃回归未能确定异质性来源。CHB患者MAFLD和HCC风险之间的关联似乎是多因素的，可能会根据地理区域和研究设计而有所不同。虽然确切的机制仍然难以捉摸，在某些亚组中表现出的潜在保护作用值得进一步研究.
